Lymphatic system-directing lipid prodrugs

ABSTRACT

The present invention provides lymphatic system-directing lipid prodrugs, pharmaceutical compositions thereof, methods of producing such prodrugs and compositions, as well as methods of improving the bioavailability or other properties of a therapeutic agent that comprises part of the lipid prodrug. The present invention also provides methods of treating a disease, disorder, or condition such as those disclosed herein, comprising administering to a patient in need thereof a provided lipid prodrug or a pharmaceutical composition thereof.

TECHNICAL FIELD

The present invention relates to compounds in the form of prodrugs, in particular, compounds that promote transport of a pharmaceutical agent to the lymphatic system and subsequently enhance release of the parent drug. The present invention also relates to compositions and methods of using such prodrugs.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Patent Application Nos. 62/551,627, filed on Aug. 29, 2017; 62/607,700, filed on Dec. 19, 2017; 62/607,749, filed on Dec. 19, 2017; 62/714,029, filed on Aug. 2, 2018; 62/724,274, filed on Aug. 29, 2018; and 62/724,440, filed on Aug. 29, 2018; the entirety of each of which is hereby incorporated by reference.

BACKGROUND OF THE INVENTION

The lymphatic system consists of a specialized network of vessels, nodes and lymphoid tissues that are distributed throughout the body in close proximity to the vascular system. The lymphatic system plays a number of key roles in immune response, fluid balance, nutrient absorption, lipid homeostasis, and tumor metastasis. Due to the unique anatomical and physiological characteristics of the lymphatic system, targeted drug delivery to and through the lymphatic system has been suggested as a means to improve both pharmacokinetic and pharmacodynamic profiles.

Lymphatic drug transport has the potential to enhance oral bioavailability through avoidance of first pass metabolism, to alter systemic drug disposition, and to enhance efficacy against lymph or lymphocyte mediated pathologies such as lymphoma, leukemia, lymphatic tumor metastasis, autoimmune disease, lymph resident infections and transplant rejection. In order for drugs to access the intestinal lymph, they must first associate with intestinal lymph lipoproteins that are assembled in intestinal absorptive cells (enterocytes) in response to lipid absorption. Association with these lipoproteins subsequently promotes drug transport into the lymph since their size precludes ready diffusion across the vascular endothelium lining the blood capillaries that drain the small intestine. Instead, these large colloidal structures enter the lymphatic capillaries since the lymphatic endothelium is considerably more permeable than that of the vascular endothelium.

Historically, drugs with high lymphatic transport have been highly lipophilic in order to promote physical association with lipoproteins (usually, but not exclusively, log D>5 and solubility in long chain triglyceride of >50 mg/g). Therefore, highly lipophilic analogues of drugs have been envisaged as one way to promote lymphatic drug transport. However, chemical modification of a parent drug can result in a reduction in potency and in many cases, significant increases in lipophilicity have been correlated with increases in toxicity.

Compounds in the form of lipophilic prodrugs provide a means to temporarily increase lipophilicity and lipoprotein affinity of a pharmaceutical compound, thereby increasing lymphatic targeting. Having been transported via the lymphatic system, the prodrug is cleaved, thereby releasing the parent drug in order to be active at its target site.

Lipophilic esters of drugs have been explored as more bioavailable versions of existing drugs. For example, testosterone undecanoate is a marketed drug for hypogonadism and other conditions. Oral administration of testosterone itself is problematic because of its extensive first pass metabolism in the liver and resulting very low bioavailability. The undecanoate ester of testosterone redirects a small proportion of the absorbed dose into the lymphatic system, thereby avoiding hepatic first pass metabolism and increasing the oral bioavailability of testosterone. However, this process is still very inefficient, and the bioavailability of testosterone after oral administration of the undecanoate ester is thought to be <5%.

Accordingly, there exists a need to develop novel lipid-pharmaceutical agent conjugates that facilitate stable transport of the pharmaceutical agent to the intestinal lymph and that readily revert to the parent active agent in order to be active.

SUMMARY OF THE INVENTION

In one aspect, the present invention provides a compound of Formula VI:

or a pharmaceutically acceptable salt thereof, wherein each variable is as defined herein.

In another aspect, the present invention provides a method of treating a disease, disorder, or condition such as one of those disclosed herein, comprising administering to a patient in need thereof an effective amount of a disclosed compound, such as a compound of Formula VI, or a pharmaceutically acceptable salt thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-17 in rats.

FIG. 2 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-18 in rats.

FIG. 3 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-19 in rats.

FIG. 4 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-20 in rats.

FIG. 5 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-21 in rats.

FIG. 6 shows lymphatic transport of phenol-conjugated mycophenolic acid prodrugs (mean±SD when n≥3 or as mean±range when n=2).

FIG. 7 shows lymphatic transport of mycophenolic acid (MPA) and mycophenolate mofetil (MMF) (mean±SD). MPA (0.13%) and MMF (0.17%) had similar, very low lymphatic transport values in rats. Both compounds were administered as an intraduodenal infusion of 2 mg compound in 5.6 mL of a lipid formulation.

FIG. 8A and FIG. 8B show measured concentrations of free mycophenolic acid (MPA) in mouse mesenteric and peripheral lymph nodes after oral administration of MPA-I-34 or MPA.

FIG. 9 shows measured concentrations of the monoglyceride form of MPA-I-20 (in which both palmitic acid groups are cleaved) and free MPA released from the monoglyceride over time in rat plasma supplemented with LPL.

FIG. 10 shows conversion of MPA-I-22 into its monoglyceride form (in which both palmitic acid groups are cleaved) and release of MPA from the monoglyceride followed over time in rat plasma supplemented with LPL.

FIG. 11 shows lymphatic transport data for MMF prodrug compound MPA-I-32. The compound was administered as an intraduodenal infusion of 2 mg compound in 5.6 mL of a lipid formulation. Lymphatic transport of approximately 40% was observed.

FIG. 12 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-43 in rats (plot of cumulative dose into lymph vs. time for each rat).

FIG. 13 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-44 in rats.

FIG. 14 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-46 in rats.

FIG. 15 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-47 in rats.

FIG. 16 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-48 in rats.

FIG. 17 shows lymphatic transport data for mycophenolic acid prodrug MPA-I-50 in rats.

FIG. 18 shows lymphatic transport data for several mycophenolic acid prodrugs (mycophenolic acid (MPA) and mycophenolate mofetil (MMF) shown for comparison).

FIG. 19 depicts the lymphatic transport of TAC-I-18 (TAC-C10-TG (32OH)) and TAC-I-20 (TAC-C12α′MeβME-TG (32OH)) as the concentration of total tacrolimus related compounds detected in the mesenteric lymph following intraduodenal infusion. In comparison, detected total tacrolimus-related compounds following administration of tacrolimus (TAC) alone was about 0.2%, below the limit of quantitation.

FIG. 20 depicts the results of in vitro release of tacrolimus from TAC-I-18 over time in rate plasma. “TAC” is tacrolimus; “MG” is the monoglyceride form of TAC-I-18; and “acid” is the released lipid prodrug moiety.

FIG. 21 depicts the in vitro release of tacrolimus from TAC-I-20 over time in rate plasma. “TAC” is tacrolimus; “MG” is the monoglyceride form of TAC-I-20; and “acid” is the released lipid prodrug moiety.

DETAILED DESCRIPTION OF THE INVENTION 1. General Description of Certain Aspects of the Invention Lymphatic System Directing Prodrugs

Compounds of the present invention, and compositions thereof, are useful in promoting transport of a therapeutic agent to the lymphatic system and in subsequently enhancing release of the parent drug, i.e. the therapeutic agent.

In one aspect, the present invention provides a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:

-   R¹ and R² are each independently hydrogen, a lipid, or —C(O)R³; -   each R³ is independently a saturated or unsaturated, straight or     branched C₂₋₃₇ hydrocarbon chain; -   X is —O—, —NR—, or —S—; -   each R is independently hydrogen or an optionally substituted C1-4     aliphatic; -   L is a covalent bond or a bivalent, saturated or unsaturated,     straight or branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene     units of L are independently replaced by -Cy-, —O—, —NR—, —S—,     —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—,     —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

wherein:

-   each -Cy- is independently an optionally substituted 5-6 membered     bivalent aryl ring having 0-4 heteroatoms independently selected     from nitrogen, oxygen, or sulfur; or -   L is

wherein:

-   R⁴ and R⁵ are each independently hydrogen or C₁₋₄ aliphatic; -   M is a self-immolative group; -   n is 0-18; -   R⁶ is hydrogen or C₁₋₄ aliphatic; and -   A is a therapeutic agent.

In one aspect, the present invention provides a compound of Formula VI:

or a pharmaceutically acceptable salt thereof, wherein:

-   -   R¹ and R² are each independently hydrogen, an acid-labile group,         a lipid, or —C(O)R³;     -   each R³ is independently a saturated or unsaturated, straight or         branched, optionally substituted C₁₋₃₇ hydrocarbon chain;     -   X is —O—, —NR—, —S—, —O(C₁₋₆ aliphatic)-O—, —O(C₁₋₆         aliphatic)-S—, —O(C₁₋₆ aliphatic)-NR—, —S(C₁₋₆ aliphatic)-O—,         —S(C₁₋₆ aliphatic)-S—, —S(C₁₋₆ aliphatic)-NR—, —NR(C₁₋₆         aliphatic)-O—, —NR(C₁₋₆ aliphatic)-S—, or —NR(C₁₋₆         aliphatic)-NR—, wherein 0-2 methylene units of the C₁₋₆         aliphatic group are independently and optionally replaced with         —O—, —NR—, or —S— and the C₁₋₆ aliphatic group is independently         and optionally substituted with 1, 2, or 3 deuterium or halogen         atoms;     -   each R is independently hydrogen or an optionally substituted         group selected from C₁₋₆ aliphatic, a 3-8 membered saturated or         partially unsaturated monocyclic carbocyclic ring, phenyl, an         8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered         saturated or partially unsaturated monocyclic heterocyclic ring         having 1-2 heteroatoms independently selected from nitrogen,         oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring         having 1-4 heteroatoms independently selected from nitrogen,         oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic         ring having 1-5 heteroatoms independently selected from         nitrogen, oxygen, or sulfur;     -   Y is absent or is —C(O)—, —C(NR)—, or —C(S)—;     -   L is a covalent bond or a bivalent, saturated or unsaturated,         straight or branched, optionally substituted bivalent C₁₋₃₀         hydrocarbon chain, wherein 0-8 methylene units of L are         independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—,         —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—,         —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid; and         wherein 1 methylene unit of L is optionally replaced with -M-;         or     -   L is

wherein either the right-hand side or left-hand side of L is attached to A;

-   -   each -Cy- is independently an optionally substituted 3-6         membered bivalent saturated, partially unsaturated, or aromatic         ring having 0-4 heteroatoms independently selected from         nitrogen, oxygen, or sulfur;     -   each R⁴ and R⁵ is independently hydrogen, deuterium, halogen,         —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially         unsaturated monocyclic carbocyclic ring, phenyl, an 8-10         membered bicyclic aromatic carbocyclic ring, a 4-8 membered         saturated or partially unsaturated monocyclic heterocyclic ring         having 1-2 heteroatoms independently selected from nitrogen,         oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring         having 1-4 heteroatoms independently selected from nitrogen,         oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic         ring having 1-5 heteroatoms independently selected from         nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group         optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered         saturated or partially unsaturated monocyclic carbocyclic ring,         phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a         4-8 membered saturated or partially unsaturated monocyclic         heterocyclic ring having 1-2 heteroatoms independently selected         from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic         heteroaromatic ring having 1-4 heteroatoms independently         selected from nitrogen, oxygen, or sulfur, or an 8-10 membered         bicyclic heteroaromatic ring having 1-5 heteroatoms         independently selected from nitrogen, oxygen, or sulfur, or the         C₁₋₆ aliphatic is optionally substituted with 1, 2, 3, 4, 5, or         6 deuterium or halogen atoms; or two instances of R⁴ or R⁵         attached to the same carbon atom, taken together with the carbon         atom to which they are attached, form a 3-6 membered saturated         monocyclic carbocyclic ring or 3-6 membered saturated         heterocyclic ring having 1-2 heteroatoms independently selected         from nitrogen, oxygen, or sulfur;     -   -M- is a self-immolative group;     -   n is 0-18;     -   each m is independently 0-6; and     -   A is a therapeutic agent.

In one aspect, the present invention provides a method of treating a disease, disorder, or condition in a patient in need thereof, comprising administering to the patient a disclosed lipid prodrug, such as a compound of Formula I or VI, or a pharmaceutically acceptable salt thereof.

It is understood that a disclosed lipid prodrug may exist in the form of a pharmaceutically acceptable salt. Thus, a reference to a “lipid prodrug” is also a disclosure of “lipid prodrug or a pharmaceutically acceptable salt thereof” It follows that such a lipid prodrug or pharmaceutically acceptable salt thereof may be used in a pharmaceutical composition and a method of use, such as those disclosed herein.

One approach to directing drugs into the lymphatic transport system is to employ prodrugs that participate in endogenous pathways that control the absorption, transport (including passive transport), and metabolism of dietary lipids. In one aspect, the present invention provides a lipid prodrug comprising a therapeutic agent conjugated to a glycerol-based moiety comprising up to two fatty acids or other lipids. Without wishing to be bound by theory, it is believed that such a prodrug mimics a dietary triglyercide, such that it participates in triglyceride processing and metabolism in the GI tract. Where appropriate, certain lipid prodrug scaffolds may be modified from the literature for use in accordance with the present disclosure. For example, certain drug-lipid conjugates and lipid prodrug scaffolds are disclosed in WO 2017/041139 and WO 2016/023082, each of which is hereby incorporated by reference in its entirety. Further examples of drug-lipid conjugates where the parent drug contains an available carboxylic acid group and has been directly conjugated to a glyceride backbone are described in Paris, G. Y. et al., J. Med. Chem. 1979, 22, (6), 683-687; Garzon Aburbeh, A. et al., J. Med. Chem. 1983, 26, (8), 1200-1203; Deverre, J. R.; et al., J. Pharm. Pharmacol. 1989, 41, (3), 191-193; Mergen, F. et al, J. Pharm. Pharmacol. 1991, 43, (11), 815-816; Garzon Aburbeh, A. et al, J. Med. Chem. 1986, 29, (5), 687-69; and Han, S. et al. J. Control. Release 2014, 177, 1-10.

Further examples have used a short linker where the drug does not contain an available carboxylic acid (Scriba, G. K. E., Arch. Pharm. (Weinheim) 1995, 328, (3), 271-276; and Scriba, G. K. E. et al, J. Pharm. Pharmacol. 1995, 47, (11), 945-948). Other examples have utilized an ester linkage to the drug and an ether linkage to the glyceride (Sugihara, J. et al., J. Pharmacobiodyn. 1988, 11, (5), 369-376; and Sugihara, J. et al., J. Pharmacobiodyn. 1988, 11, (8), 555-562).

Typical use of prodrug strategies to improve a therapeutic agent's (active pharmaceutical agent's) pharmacokinetic properties relies on cleavage in vivo to the parent agent via non-specific degradation or enzymatic cleavage, thus allowing the agent to exert its biological activity. The present invention, in one aspect, provides modified glyceride-based compounds (lipid prodrugs) that direct lymphatic transport of a therapeutic agent and improve cleavage of the lipid prodrug to the therapeutic agent.

Dietary lipids, including triglycerides, follow a particular metabolic pathway to gain access to the lymph (and ultimately the systemic circulation) that is entirely distinct from that of other nutrients such as proteins and carbohydrates. After ingestion, dietary triglycerides are hydrolyzed by lipases in the lumen to release one monoglyceride and two fatty acids for each molecule of triglyceride. The monoglyceride and two fatty acids are subsequently absorbed into enterocytes and re-esterified to triglycerides.

Resynthesised triglycerides are assembled into intestinal lipoproteins, primarily chylomicrons. After formation, chylomicrons are exocytosed from enterocytes and subsequently gain preferential access to the intestinal lymphatics. Once within the lymphatic system, chylomicrons containing packaged triglycerides drain through a series of capillaries, nodes and ducts to join the systemic circulation at the junction of the left subclavian vein and internal jugular vein. Following entry into blood circulation, triglycerides in chylomicrons are preferentially and efficiently taken up by tissues with high expression levels of lipoprotein lipases, such as adipose tissue, the liver, and potentially certain types of tumor tissues.

Lipid prodrugs are expected to behave similarly to natural triglycerides and to be transported to and through the lymphatic system to reach the systemic circulation without interacting with the liver. In some embodiments, the lipid prodrugs are cleaved, releasing the therapeutic agent, after the prodrugs have reached the systemic circulation, or after reaching a target tissue. In some embodiments, the lipid prodrugs release the therapeutic agent by destruction of a self-immolative linker that attaches the therapeutic agent to the glyercol-derived group, or by enzymatic cleavage of a linker. In this way, the pharmacokinetic and pharmacodynamic profiles of the parent therapeutic agent may be manipulated to enhance access to the lymph and lymphoid tissues, thereby promoting oral bioavailability via avoidance of first-pass metabolism (and potentially intestinal efflux). Accordingly, in some embodiments, the disclosed lipid prodrug has improved oral bioavailability, reduced first-pass metabolism, reduced liver toxicity, or improved other pharmacokinetic properties as compared with the parent therapeutic agent. In some embodiments, the disclosed lipid prodrug has increased drug targeting (as compared with the parent therapeutic agent) to sites within the lymph, lymph nodes and lymphoid tissues, and to sites of high lipid utilization and lipoprotein lipase expression such as adipose tissue, liver and some tumours.

In certain aspects, the present invention provides methods of modulating the delivery, distribution, or other properties of a therapeutic agent. In one aspect, the present invention provides a method of delivering a therapeutic agent to the systemic circulation of a patient in need thereof, wherein the therapeutic agent partially, substantially, or completely bypasses first-pass liver metabolism in the patient, comprising the step of administering to the patient a disclosed lipid prodrug of the therapeutic agent. In another aspect, the present invention provides a method of modifying a therapeutic agent to partially, substantially, or completely bypass first-pass liver metabolism in a patient after administration of the therapeutic agent, comprising the step of preparing a disclosed lipid prodrug of the therapeutic agent. In some embodiments, the lipid prodrug is administered orally. In some embodiments, preparing the lipid prodrug comprises the step of conjugating a therapeutic agent to a glycerol-based scaffold comprising two fatty acids or other lipids, thereby providing the lipid prodrug.

In another aspect, the present invention provides a method of improving oral bioavailability of a therapeutic agent, enhancing gut absorption of a therapeutic agent, or decreasing metabolism, decomposition, or efflux in the gut of a therapeutic agent, comprising the step of preparing a disclosed lipid prodrug of the therapeutic agent.

In another aspect, the present invention provides a method of modifying, e.g., improving, delivery of a therapeutic agent to a target tissue, comprising the step of preparing a disclosed lipid prodrug of the therapeutic agent. In some embodiments, the target tissue is the lymph, a lymph node (such as a mesenteric lymph node), adipose tissue, liver, or a tumor, such as a lymph node site of metastasis.

Lipid prodrugs that readily convert to parent therapeutic agent after transport via the systemic circulation have reduced free drug concentrations in the gastrointestinal (GI) tract, which may provide benefits in reducing gastrointestinal irritation or toxicity, and/or in increased drug solubility in intestinal bile salt micelles (due to similarities to endogenous monoglycerides). Disclosed lipid prodrugs may also in certain embodiments have increased passive membrane permeability (due to greater lipophilicity compared with the parent therapeutic agent). In some embodiments, the lipid prodrug has greater solubility in lipid formulations or vehicles comprising either lipids alone or mixtures of lipids with surfactants and/or cosolvents, allowing for the use of lipophilic formulations for otherwise highly hydrophilic therapeutic agents.

In one aspect, the present invention provides a compound of Formula I:

or a pharmaceutically acceptable salt thereof, wherein:

-   R¹ and R² are each independently hydrogen, a lipid, or —C(O)R³; -   each R³ is independently a saturated or unsaturated, straight or     branched C₂₋₃₇ hydrocarbon chain; X is —O—, —NR—, or —S—; -   each R is independently hydrogen or an optionally substituted C₁₋₄     aliphatic; -   L is a covalent bond or a bivalent, saturated or unsaturated,     straight or branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene     units of L are independently replaced by -Cy-, —O—, —NR—, —S—,     —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—,     —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

wherein:

-   each -Cy- is independently an optionally substituted 5-6 membered     bivalent aryl ring having 0-4 heteroatoms independently selected     from nitrogen, oxygen, or sulfur; or -   L is wherein:

-   R⁴ and R⁵ are each independently hydrogen or C₁₋₄ aliphatic; -   M is a self-immolative group; -   n is 0-18; -   R⁶ is hydrogen or C₁₋₄ aliphatic; and -   A is a therapeutic agent.

As defined above and described herein, R¹ and R² are each independently hydrogen, a lipid such as a fatty acid, or —C(O)R₃.

In some embodiments, R¹ is hydrogen. In some embodiments, R¹ is a lipid. In some embodiments, R¹ is a fatty acid. In some embodiments, R¹ is —C(O)R³.

In some embodiments, R¹ is selected from those depicted in Table A, below.

In some embodiments, R² is hydrogen. In some embodiments, R² is a lipid. In some embodiments, R² is a fatty acid. In some embodiments, R² is —C(O)R³.

In some embodiments, R² is selected from those depicted in Table A, below.

As defined above and described herein, each R³ is independently a saturated or unsaturated, straight or branched C₂₋₃₇ hydrocarbon chain.

In some embodiments, R³ is a saturated, straight C₂₋₃₇ hydrocarbon chain. In some embodiments, R³ is an unsaturated, straight C₂₋₃₇ hydrocarbon chain. In some embodiments, R³ is a saturated, branched C₂₋₃₇ hydrocarbon chain. In some embodiments, R³ is an unsaturated, branched C₂₋₃₇ hydrocarbon chain.

In some embodiments, R³ is selected from those depicted in Table A, below.

As defined above and described herein, X is —O—, —NR—, or —S—.

In some embodiments, X is —O—. In some embodiments, X is —NR—. In some embodiments, X is —S—.

In some embodiments, X is selected from those depicted in Table A, below.

As defined above and described herein, each R is independently hydrogen or an optionally substituted C₁₋₄ aliphatic.

In some embodiments, R is hydrogen. In some embodiments, R is an optionally substituted C₁₋₄ aliphatic.

In some embodiments, R is selected from those depicted in Table A, below.

As defined above and described herein, L is a covalent bond or a bivalent, saturated or unsaturated, straight or branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

In some embodiments, L is a covalent bond. In some embodiments, L is a bivalent, saturated, straight C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

In some embodiments, L is a bivalent, saturated, branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

In some embodiments, L is a bivalent, unsaturated, straight C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

In some embodiments, L is a bivalent, unsaturated, branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—.

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L is selected from those depicted in Table A, below.

As defined above and described herein, each -Cy- is independently an optionally substituted 5-6 membered bivalent aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, -Cy- is an optionally substituted 5-6 membered bivalent aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, -Cy- is an optionally substituted 5 membered bivalent aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, -Cy- is an optionally substituted 6 membered bivalent aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, -Cy- is selected from those depicted in Table A, below.

As defined above and described herein, L is

In some embodiments, L is

In some embodiments, L is

In some embodiments, L is

In some embodiments, L is selected from those depicted in Table A, below.

As defined above and described herein, R⁴ and R⁵ are each independently hydrogen or C₁₋₄ aliphatic.

In some embodiments, R⁴ is hydrogen. In some embodiments, R⁴ is C₁₋₄ aliphatic. In some embodiments, R⁴ is methyl. In some embodiments, R⁴ is ethyl. In some embodiments, R⁴ is n-propyl. In some embodiments, R⁴ is isopropyl. In some embodiments, R⁴ is cyclopropyl or cyclobutyl. In some embodiments, R⁴ is n-butyl. In some embodiments, R⁴ is sec-butyl. In some embodiments, R⁴ is isobutyl. In some embodiments, R⁴ is tert-butyl. In some embodiments, R⁴ is selected from those depicted in Table A, below.

In some embodiments, R⁵ is hydrogen. In some embodiments, R⁵ is C₁₋₄ aliphatic. In some embodiments, R⁵ is methyl. In some embodiments, R⁵ is ethyl. In some embodiments, R⁵ is n-propyl. In some embodiments, R⁵ is isopropyl. In some embodiments, R⁵ is cyclopropyl or cyclobutyl. In some embodiments, R⁵ is n-butyl. In some embodiments, R⁵ is sec-butyl. In some embodiments, R⁵ is isobutyl. In some embodiments, R⁵ is tert-butyl. In some embodiments, R⁴ is selected from those depicted in Table 1, below. In some embodiments, R⁵ is selected from those depicted in Table A, below.

As defined above and described herein, M is a self-immolative group.

In some embodiments, M is a self-immolative group.

In some embodiments, M is

In some embodiments, M is

In some embodiments, M is

In some embodiments, M is

In some embodiments, M is

In some embodiments, M is

In some embodiments, M is selected from those depicted in Table A, below.

As defined above and described herein, n is 0-18.

In some embodiments, n is 0. In some embodiments, n is 1. In some embodiments, n is 2. In some embodiments, n is 3. In some embodiments, n is 4. In some embodiments, n is 5. In some embodiments, n is 6. In some embodiments, n is 7. In some embodiments, n is 8. In some embodiments, n is 9. In some embodiments, n is 10. In some embodiments, n is 11. In some embodiments, n is 12. In some embodiments, n is 13. In some embodiments, n is 14. In some embodiments, n is 15. In some embodiments, n is 16. In some embodiments, n is 17. In some embodiments, n is 18.

In some embodiments, n is selected from those depicted in Table A, below.

As defined above and described herein, R⁶ is hydrogen or C₁₋₄ aliphatic.

In some embodiments, R⁶ is hydrogen. In some embodiments, R⁶ is C₁₋₄ aliphatic. In some embodiments, R⁶ is methyl. In some embodiments, R⁶ is ethyl. In some embodiments, R⁶ is n-propyl. In some embodiments, R⁶ is isopropyl. In some embodiments, R⁶ is n-butyl. In some embodiments, R⁶ is isobutyl. In some embodiments, R⁶ is tert-butyl.

In some embodiments, R⁶ is selected from those depicted in Table A, below.

As defined above and described herein, A is a therapeutic agent.

In some embodiments, A is a therapeutic agent.

In some embodiments, A is a therapeutic agent selected from any of those set forth in Tables 1-7, or a derivative thereof, below.

One of ordinary skill in the art will appreciate that certain therapeutic agents listed in Tables 1-7 are in the form of prodrugs. For example, mycophenolate mofetil is a prodrug of a mycophenolic acid. Thus, it will be appreciated that a lipid prodrug moiety of the present invention is attached to the therapeutic agent or the active form thereof. For the purpose of clarity, and by way of example, it will be understood that a provided lipid prodrug moiety is attached at any modifiable oxygen, sulfur, or nitrogen atom of the therapeutic agent, e.g. either mycophenolate mofetil or mycophenolic acid.

In some embodiments, A is selected from those depicted in Table A, below.

In one aspect, the present invention provides a compound of Formula VI:

or a pharmaceutically acceptable salt thereof, wherein:

-   R¹ and R² are each independently hydrogen, an acid-labile group, a     lipid, or —C(O)R³; -   each R³ is independently a saturated or unsaturated, straight or     branched, optionally substituted C₁₋₃₇ hydrocarbon chain; -   X is —O—, —NR—, —S—, —O(C₁₋₆ aliphatic)-O—, —O(C₁₋₆ aliphatic)-S—,     —O(C₁₋₆ aliphatic)-NR—, —S(C₁₋₆ aliphatic)-O—, —S(C₁₋₆     aliphatic)-S—, —S(C₁₋₆ aliphatic)-NR—, —NR(C₁₋₆ aliphatic)-O—,     —NR(C₁₋₆ aliphatic)-S—, or —NR(C₁₋₆ aliphatic)-NR—, wherein 0-2     methylene units of the C₁₋₆ aliphatic group are independently and     optionally replaced with —O—, —NR—, or —S— and the C₁₋₆ aliphatic     group is independently and optionally substituted with 1, 2, or 3     deuterium or halogen atoms; -   each R is independently hydrogen or an optionally substituted group     selected from C₁₋₆ aliphatic, a 3-8 membered saturated or partially     unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered     bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or     partially unsaturated monocyclic heterocyclic ring having 1-2     heteroatoms independently selected from nitrogen, oxygen, or sulfur,     a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, or an 8-10     membered bicyclic heteroaromatic ring having 1-5 heteroatoms     independently selected from nitrogen, oxygen, or sulfur; -   Y is absent or is —C(O)—, —C(NR)—, or —C(S)—; -   L is a covalent bond or a bivalent, saturated or unsaturated,     straight or branched, optionally substituted bivalent C₁₋₃₀     hydrocarbon chain, wherein 0-8 methylene units of L are     independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—,     —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—,     —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid; and wherein 1     methylene unit of L is optionally replaced with -M-; or -   L is

wherein either the right-hand side or left-hand side of L is attached to A;

-   each -Cy- is independently an optionally substituted 3-6 membered     bivalent saturated, partially unsaturated, or aromatic ring having     0-4 heteroatoms independently selected from nitrogen, oxygen, or     sulfur; -   each R⁴ and R⁵ is independently hydrogen, deuterium, halogen, —CN,     —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated     monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic     aromatic carbocyclic ring, a 4-8 membered saturated or partially     unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, a 5-6     membered monocyclic heteroaromatic ring having 1-4 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, or an 8-10     membered bicyclic heteroaromatic ring having 1-5 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆     aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a     3-8 membered saturated or partially unsaturated monocyclic     carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic     carbocyclic ring, a 4-8 membered saturated or partially unsaturated     monocyclic heterocyclic ring having 1-2 heteroatoms independently     selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic     heteroaromatic ring having 1-4 heteroatoms independently selected     from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic     heteroaromatic ring having 1-5 heteroatoms independently selected     from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic is     optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen     atoms; or     -   two instances of R⁴ or R⁵ attached to the same carbon atom,         taken together with the carbon atom to which they are attached,         form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6         membered saturated heterocyclic ring having 1-2 heteroatoms         independently selected from nitrogen, oxygen, or sulfur;         -M- is a self-immolative group;         n is 0-18;         each m is independently 0-6; and         A is a therapeutic agent.

As defined above and described herein, R¹ and R² are each independently hydrogen, an acid-labile group, a lipid such as a fatty acid, or —C(O)R³.

In some embodiments, R¹ is hydrogen. In some embodiments, R¹ is an acid-labile group. In some embodiments, R¹ is a lipid. In some embodiments, R¹ is a fatty acid. In some embodiments, R¹ is —C(O)R³. In some embodiments, R¹ is selected from those depicted in Table A, below.

In some embodiments, R² is hydrogen. In some embodiments, R² is an acid-labile group. In some embodiments, R² is a lipid. In some embodiments, R² is a fatty acid. In some embodiments, R² is —C(O)R³. In some embodiments, R² is selected from those depicted in Table A, below.

In some embodiments, each of R¹ and R² is independently a fatty acid, phosphatide, phospholipid, or analogue thereof, such as those described in detail below. In some embodiments, each fatty acid is independently a saturated or unsaturated medium-chain or long-chain fatty acid. In some embodiments, each fatty acid independently has a C₂-C₄₀ chain. In some embodiments, each fatty acid independently has a C₆-C₂₀, C₈-C₂₀, C₁₀-C₂₀, C₁₀-C₁₈, C₁₂-C₁₈, C₁₄-C₁₈, C₁₆-C₁₈, or C₁₀-C₁₆ chain. In some embodiments, each fatty acid is independently selected from oleic acid, palmitic acid, EPA, or DHA.

In some embodiments, R¹ and R² are each independently selected from an acid labile group such as tert-butoxycarbonyl (Boc), an amino acid, PEG group, —C(O)OR, —C(O)NR₂, —CH₂OR, —C(NR)R, or —P(O)₂OR.

As defined above and described herein, each R³ is independently a saturated or unsaturated, straight or branched, optionally substituted C₁₋₃₇ hydrocarbon chain.

In some embodiments, R³ is a saturated, straight, optionally substituted C₁₋₃₇ hydrocarbon chain. In some embodiments, R³ is an unsaturated, straight, optionally substituted C₁₋₃₇ hydrocarbon chain. In some embodiments, R³ is a saturated, branched, optionally substituted C₁₋₃₇ hydrocarbon chain. In some embodiments, R³ is an unsaturated, branched, optionally substituted C₁₋₃₇ hydrocarbon chain. In some embodiments, R³ is selected from those depicted in Table A, below.

As defined above and described herein, X is —O—, —NR—, —S—, —O (C₁₋₆ aliphatic)-O—, —O(C₁₋₆ aliphatic)-S—, —O(C₁₋₆ aliphatic)-NR—, —S(C₁₋₆ aliphatic)-O—, —S(C₁₋₆ aliphatic)-S—, —S(C₁₋₆ aliphatic)-NR—, —NR(C₁₋₆ aliphatic)-O—, —NR(C₁₋₆ aliphatic)-S—, or —NR(C₁₋₆ aliphatic)-NR—, wherein 0-2 methylene units of the C₁₋₆ aliphatic group are independently and optionally replaced with —O—, —NR—, or —S— and the C₁₋₆ aliphatic group is independently and optionally substituted with 1, 2, or 3 deuterium or halogen atoms.

In some embodiments, X is —O—. In some embodiments, X is —NR—. In some embodiments, X is —S—. In some embodiments, X is —O(C₁₋₆ aliphatic)-O—. In some embodiments, X is —O(C₁₋₆ aliphatic)-S—. In some embodiments, X is —O(C₁₋₆ aliphatic)-NR—. In some embodiments, X is —S(C₁₋₆ aliphatic)-O—. In some embodiments, X is —S(C₁₋₆ aliphatic)-S—. In some embodiments, X is —S(C₁₋₆ aliphatic)-NR—. In some embodiments, X is —NR(C₁₋₆ aliphatic)-O—. In some embodiments, X is —NR(C₁₋₆ aliphatic)-S—. In some embodiments, X is —NR(C₁₋₆ aliphatic)-NR—. In any of the foregoing embodiments, 0-2 methylene units of the bivalent C₁₋₆ aliphatic group are independently and optionally replaced with —O—, —NR—, or —S— and the bivalent C₁₋₆ aliphatic group is independently and optionally substituted with 1, 2, or 3 deuterium or halogen atoms. In some embodiments, X is selected from those depicted in Table A, below.

As defined above and described herein, Y is absent or is —C(O)—, —C(NR)—, or —C(S)—.

In some embodiments, Y is absent. In some embodiments, Y is —C(O)—. In some embodiments, Y is —C(NR)—. In some embodiments, Y is —C(S)—. In some embodiments, Y is selected from those depicted in Table A, below.

As defined above and described herein, L is a covalent bond or a bivalent, saturated or unsaturated, straight or branched, optionally substituted bivalent C₁₋₃₀ hydrocarbon chain, wherein 0-8 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid; and wherein 1 methylene unit of L is optionally replaced with -M-; or L is

wherein either the right-hand side or left-hand side of L is attached to A.

In some embodiments, L is a covalent bond. In some embodiments, L is a bivalent, saturated or unsaturated, straight or branched, optionally substituted bivalent C₁₋₃₀ (e.g., C₃₋₃₀, C₅₋₃₀, C₇₋₃₀, C₃₋₂₅, C₅₋₂₅, C₇₋₂₅, C₃₋₂₀, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, C₆₋₁₂, etc.) hydrocarbon chain, wherein 0-8 (i.e., 0, 1, 2, 3, 4, 5, 6, 7, or 8) methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid; and wherein 1 methylene unit of L is optionally replaced with -M-. In some embodiments, L is

wherein either the right-hand side or left-hand side of L is attached to A.

In some embodiments, L is a covalent bond or a bivalent, saturated or unsaturated, straight or branched, optionally substituted bivalent C₁₋₃₀ (e.g., C₃₋₃₀, C₅₋₃₀, C₇₋₃₀, C₃₋₂₅, C₅₋₂₅, C₇₋₂₅, C₃₋₂₀, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, C₆₋₁₂, etc.) hydrocarbon chain, wherein 0-8 (i.e., 0, 1, 2, 3, 4, 5, 6, 7, or 8) methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid selected from

and wherein 1 methylene unit of L is optionally replaced with -M-; or

L is

wherein either the right-hand side or left-hand side of L is attached to A.

In some embodiments, L is a bivalent, saturated or unsaturated, straight or branched, optionally substituted bivalent C₁₋₂₀ (e.g., C₃₋₂₀, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, C₆₋₁₂, etc.) hydrocarbon chain, wherein 0-8 (i.e., 0, 1, 2, 3, 4, 5, 6, 7, or 8) methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or a naturally-occurring amino acid such as

and wherein 1 methylene unit of L is optionally replaced with -M-. In some embodiments, L is a covalent bond or a bivalent, saturated or unsaturated, straight or branched C₃₋₁₆, C₅₋₁₂, C₈₋₁₆ or C₆₋₁₆ hydrocarbon chain, wherein 0-6, 0-4, 0-3, or 0-1 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —C(S)—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—,

and 1 methylene unit of L is optionally replaced with -M-. In some embodiments, L is a bivalent, saturated, straight C₃₋₂₀, C₅₋₁₆, C₆₋₁₂, C₇₋₂₀, C₅₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, or C₆₋₁₂ hydrocarbon chain, wherein 0-6, 0-4, 0-3, or 0-1 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—; and 1 methylene unit of L is optionally replaced with -M-. In some embodiments, L is a bivalent, saturated, straight C₃₋₂₀, C₅₋₁₆, C₆₋₁₂, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, or C₆₋₁₂ hydrocarbon chain, wherein 0-6, 0-4, 0-3, or 0-1 methylene units of L are independently replaced by —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, or —C(S)—; and 1 methylene unit of L is optionally replaced with -M-.

In some embodiments, L is a bivalent, saturated C₃₋₃₀, C₅₋₂₅, C₆₋₂₀, C₈₋₂₀, C₁₀₋₁₈, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, or C₆₋₁₂ hydrocarbon chain optionally substituted with 1, 2, 3, or 4 R⁴ groups, wherein 0-4 methylene units of L are independently replaced by —O—, —OC(O)—, —C(O)O—, or —C(O)—; and 1 methylene unit of L is optionally replaced with -M-.

In some embodiments, L is a bivalent, saturated C₁₋₂₅, C₅₋₂₅, C₅₋₂₀, C₇₋₂₀, C₈₋₁₈, C₆₋₁₈, C₇₋₁₇, C₈₋₁₆, C₈₋₁₅, C₈₋₁₄, C₇₋₁₃, or C₆₋₁₂ hydrocarbon chain optionally substituted with 1, 2, 3, or 4 groups selected from deuterium, halogen, —CN, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 4-6 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; wherein 0-4 methylene units of L are independently replaced by —O—, —OC(O)—, —C(O)O—, or —C(O)—; and 1 methylene unit of L is optionally replaced with -M-.

In some embodiments, L comprises (—OCH₂CH₂-)₁₋₈ (i.e., 1-8 polyethylene glycol (PEG) units). In some embodiments, L comprises 1, 2, 3, 4, 5, 6, 7, or 8 PEG units.

In some embodiments, 0-6 units of L are independently replaced by —O—, —S—, —OC(O)—, —C(O)O—, —C(O)—, or —C(S)—; and 1 methylene unit of L is optionally replaced with -M-.

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, L comprises

In some embodiments, 1 methylene unit of L is replaced with -M-.

In some embodiments, 1, 2, 3, or 4 available hydrogen atoms of L are replaced with an R⁴ group, i.e., L is optionally substituted with 1, 2, 3, or 4 R⁴ groups.

In some embodiments, a methylene unit of L is replaced with an amino acid. The amino acid may be naturally-occurring or non-naturally occurring. In some embodiments, the amino acid is selected from a non-polar or branched chain amino acid (BCAA). In some embodiments, the amino acid is selected from valine, isoleucine, leucine, methionine, alanine, proline, glycine, phenylalanine, tyrosine, tryptophan, histidine, asparagine, glutamine, serine threonine, lysine, arginine, histidine, aspartic acid, glutamic acid, cysteine, selenocysteine, or tyrosine. In some embodiments, the amino acid is an L-amino acid. In some embodiments, the amino acid is a D-amino acid.

In some embodiments, L is selected from those depicted in Table A, below.

As defined above and described herein, each -Cy- is independently an optionally substituted 3-6 membered bivalent saturated, partially unsaturated, or aromatic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, -Cy- is an optionally substituted 3-6 membered bivalent saturated ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, -Cy- is an optionally substituted 5-membered bivalent saturated, partially unsaturated, or aromatic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, -Cy- is an optionally substituted 6-membered bivalent saturated, partially unsaturated, or aromatic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, -Cy- is selected from those depicted in Table A, below.

As defined above and described herein, each R⁴ and R⁵ is independently hydrogen, deuterium, halogen, —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁴ or R⁵ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, R⁴ is hydrogen. In some embodiments, R⁴ is deuterium. In some embodiments, R⁴ is halogen. In some embodiments, R⁴ is —CN. In some embodiments, R⁴ is —OR. In some embodiments, R⁴ is —NR₂. In some embodiments, R⁴ is —SR. In some embodiments, R⁴ is a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring. In some embodiments, R⁴ is phenyl. In some embodiments, R⁴ is an 8-10 membered bicyclic aromatic carbocyclic ring. In some embodiments, R⁴ is a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁴ is a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁴ is an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁴ is a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁴ is a C₁₋₆ aliphatic group optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, two instances of R⁴ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, each R⁴ is independently hydrogen, deuterium, halogen, —CN, or C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁴ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, at least one instance of R⁴ is not hydrogen.

In some embodiments, R⁴ is C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, R⁴ is C₁₋₄ alkyl optionally substituted with 1, 2, or 3 deuterium or halogen atoms. In some embodiments, R⁴ is methyl optionally substituted with 1, 2, or 3 deuterium or halogen atoms. In some embodiments, R⁴ is ethyl. In some embodiments, R⁴ is n-propyl. In some embodiments, R⁴ is isopropyl. In some embodiments, R⁴ is n-butyl. In some embodiments, R⁴ is isobutyl. In some embodiments, R⁴ is tert-butyl. In some embodiments, R⁴ is selected from those depicted in Table A, below.

In some embodiments, R⁵ is hydrogen. In some embodiments, R⁵ is deuterium. In some embodiments, R⁵ is halogen. In some embodiments, R⁵ is —CN. In some embodiments, R⁵ is —OR. In some embodiments, R⁵ is —NR₂. In some embodiments, R⁵ is —SR. In some embodiments, R⁵ is a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring. In some embodiments, R⁵ is phenyl. In some embodiments, R⁵ is an 8-10 membered bicyclic aromatic carbocyclic ring. In some embodiments, R⁵ is a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁵ is a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁵ is an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁵ is a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁵ is a C₁₋₆ aliphatic group optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, two instances of R⁵ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, each R⁵ is independently hydrogen, deuterium, halogen, —CN, or C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁵ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

In some embodiments, at least one instance of R⁵ is not hydrogen.

In some embodiments, R⁵ is C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, R⁵ is methyl optionally substituted with 1, 2, or 3 deuterium or halogen atoms. In some embodiments, R⁵ is ethyl. In some embodiments, R⁵ is n-propyl. In some embodiments, R⁵ is isopropyl. In some embodiments, R⁵ is n-butyl. In some embodiments, R⁵ is isobutyl. In some embodiments, R⁵ is tert-butyl. In some embodiments, R⁵ is selected from those depicted in Table A, below.

As defined above and described herein, -M- is a self-immolative group.

In some embodiments, -M- is an acetal, an o-benzylalcohol, a p-benzylalcohol, a styryl group, a coumarin, or a group that self-immolates via a cyclization reaction. In some embodiments, -M- is selected from a disulfide, hydrazone, acetal self-immolative group, carboxyacetal self-immolative group, carboxy(methylacetal) self-immolative group, para-hydroxyb enzyl self-immolative group, para-hydroxybenzyl carbonyl self-immolative group, flipped ester self-immolative group, trimethyl lock self-immolative group, or 2-hydroxyphenyl carbamate (2-HPC) self-immolative group.

In some embodiments, -M- is selected from one of the following:

-   wherein each R⁶ is independently selected from hydrogen, deuterium,     C₁₋₁₀ aliphatic, halogen, or —CN; -   each R⁷ is independently selected from hydrogen, deuterium, halogen,     —CN, —OR, —NR₂, —NO2, —SR, a 3-8 membered saturated or partially     unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered     bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or     partially unsaturated monocyclic heterocyclic ring having 1-2     heteroatoms independently selected from nitrogen, oxygen, or sulfur,     a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, or an 8-10     membered bicyclic heteroaromatic ring having 1-5 heteroatoms     independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆     aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a     3-8 membered saturated or partially unsaturated monocyclic     carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic     carbocyclic ring, a 4-8 membered saturated or partially unsaturated     monocyclic heterocyclic ring having 1-2 heteroatoms independently     selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic     heteroaromatic ring having 1-4 heteroatoms independently selected     from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic     heteroaromatic ring having 1-5 heteroatoms independently selected     from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic is     optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen     atoms;

each Z¹ is independently selected from —O—, —NR—, or —S—;

each Z² is independently selected from —O—, —NR—, —S—, —OC(O)—, —NRC(O)O—, or —OC(O)NR—;

each Z³ is independently selected from ═N— or ═C(R⁷)—; and

each Z⁴ is independently selected from —O—, —NR—, —S—, —C(R⁶)₂—, or a covalent bond.

As defined generally above and described herein, each R⁶ is independently selected from hydrogen, deuterium, C₁₋₁₀ aliphatic, halogen, or —CN. In some embodiments, R⁶ is hydrogen. In some embodiments, R⁶ is deuterium. In some embodiments, R⁶ is C₁₋₁₀ aliphatic. In some embodiments, R⁶ is halogen. In some embodiments, R⁶ is —CN.

In some embodiments, R⁶ is hydrogen, C₁₋₅ alkyl, halogen, or —CN. In some embodiments, R⁶ is hydrogen or C₁₋₃ alkyl. In some embodiments, R⁶ is hydrogen or methyl.

In some embodiments, each instance of R⁶ in the above formulae is the same. In some embodiments, each R⁶ is different. In some embodiments, one R⁶ is hydrogen. In some embodiments, one R⁶ is C₁₋₅ aliphatic. In some embodiments, each R⁶ is hydrogen. In some embodiments, each R⁶ is C₁₋₅ aliphatic. In some embodiments, R⁶ is selected from those depicted in Table A, below.

As defined generally above and described herein, each R⁷ is independently selected from hydrogen, deuterium, halogen, —CN, —OR, —NR₂, —NO₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic group is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms.

In some embodiments, R⁷ is hydrogen. In some embodiments, R⁷ is deuterium. In some embodiments, R⁷ is halogen. In some embodiments, R⁷ is —CN. In some embodiments, R⁷ is —OR. In some embodiments, R⁷ is —NR₂. In some embodiments, R⁷ is —NO₂. In some embodiments, R⁷ is —SR. In some embodiments, R⁷ is a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring. In some embodiments, R⁷ is phenyl. In some embodiments, R⁷ is an 8-10 membered bicyclic aromatic carbocyclic ring. In some embodiments, R⁷ is a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁷ is a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁷ is or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁷ is or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur. In some embodiments, R⁷ is a C₁₋₆ aliphatic group optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms.

In some embodiments, R⁷ is hydrogen, deuterium, halogen, —CN, —OR, —NR₂, —NO₂, —SR, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 4-6 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, or a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic group is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, R⁷ is hydrogen, deuterium, halogen, —CN, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₄ alkyl group optionally substituted with —CN, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, or a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₄ alkyl group is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms. In some embodiments, R⁷ is hydrogen, halogen, —CN, —OR, or C₁₋₄ alkyl.

In some embodiments, R is hydrogen or C₁₋₄ alkyl.

In some embodiments, R⁷ is selected from those depicted in Table A, below.

As defined generally above and described herein, each Z¹ is independently selected from —O—, —NR—, or —S—. In some embodiments, Z¹ is —O—. In some embodiments, Z¹ is —NR—. In some embodiments, Z¹ is —S. In some embodiments, Z¹ is —NH— or —NMe-.

In some embodiments, Z¹ is selected from those depicted in Table A, below.

As defined generally above and described herein, each Z² is independently selected from —O—, —NR—, —S—, —OC(O)—, —NRC(O)O—, or —OC(O)NR—.

In some embodiments, Z² is —O—. In some embodiments, Z² is —NR—. In some embodiments, Z² is -5-. In some embodiments, Z² is —OC(O)—. In some embodiments, Z² is —NRC(O)O—. In some embodiments, Z² is —OC(O)NR—.

In some embodiments, each Z² is independently selected from —O—, —NH—, —NMe-, —S—, —OC(O)—, —NHC(O)O—, —NMeC(O)O—, —OC(O)NH—, or —OC(O)NMe-.

In some embodiments, Z² is covalently bound to A. In some embodiments, Z² is —O— or —OC(O)O—.

In some embodiments, Z² is selected from those depicted in Table A, below.

In some embodiments, Z¹ is —O— and Z² is —O— or —OC(O)O—.

As defined generally above and described herein, each Z³ is independently selected from ═N— or ═C(R⁷)—. In some embodiments, Z³ is ═N—. In some embodiments, Z³ is ═C(R⁷)—.

In some embodiments, Z³ is selected from those depicted in Table A, below.

As defined generally above and described herein, each Z⁴ is independently selected from —O—, —NR—, —S—, —C(R⁶)₂—, or a covalent bond. In some embodiments, Z⁴ is —O—. In some embodiments, Z⁴ is —NR—. In some embodiments, Z⁴ is —S—. In some embodiments, Z⁴ is —C(R⁶)₂—. In some embodiments, Z⁴ is a covalent bond.

In some embodiments, Z⁴ is selected from those depicted in Table A, below.

In some embodiments, -M- is selected from one of the following:

In some embodiments, -M- is selected from

In some embodiments, -M- is selected from

In some embodiments, -M- is selected from those depicted in Table A, below.

As defined above and described herein, n is 0-18.

In some embodiments, n is 0. In some embodiments, n is 1. In some embodiments, n is 2. In some embodiments, n is 3. In some embodiments, n is 4. In some embodiments, n is 5. In some embodiments, n is 6. In some embodiments, n is 7. In some embodiments, n is 8. In some embodiments, n is 9. In some embodiments, n is 10. In some embodiments, n is 11. In some embodiments, n is 12. In some embodiments, n is 13. In some embodiments, n is 14. In some embodiments, n is 15. In some embodiments, n is 16. In some embodiments, n is 17. In some embodiments, n is 18. In some embodiments, n is 1-16, 1-14, 1-12, 1-10, 1-8, 1-6, 1-3, 2-16, 2-14, 2-12, 2-10, 2-8, 2-6, 3-12, 3-8, 3-6, 4-10, 4-8, 4-6, 5-10, 5-8, 5-6, 6-18, 6-10, 6-8, 8-12, 5-18, 5-13, 8-18, 8-17, 8-16, 8-15, 8-16, or 6-16.

As defined above and described herein, each m is independently 0-6. In some embodiments, m is 0. In some embodiments, m is 1. In some embodiments, m is 2. In some embodiments, m is 3. In some embodiments, m is 4. In some embodiments, m is 5. In some embodiments, m is 6. In some embodiments, each m is independently 0, 1, or 2. In some embodiments, each m is independently 1, 2, 3, or 4.

As defined above and described herein, A is a therapeutic agent.

In some embodiments, A is a therapeutic agent selected from any of those set forth in Tables 1-7, or a derivative thereof, below.

One of ordinary skill in the art will appreciate that certain therapeutic agents listed in Tables 1-7 are in the form of prodrugs. For example, mycophenolate mofetil is a prodrug of a mycophenolic acid. Thus, it will be appreciated that a lipid prodrug moiety of the present invention is attached to the prodrug of the therapeutic agent or the active form of the prodrug. For the purpose of clarity, and by way of example, it will be understood that a provided lipid prodrug moiety is attached at any modifiable oxygen, sulfur, or nitrogen atom of the therapeutic agent, e.g. either mycophenolate mofetil or mycophenolic acid.

In some embodiments, a disclosed lipid prodrug comprises one or two lipids covalently bound to one or two of the hydroxyl groups of the glyceride-based group shown in, e.g. Formula I or VI.

In some embodiments, a disclosed lipid prodrug further comprises a lipid covalently bound to the therapeutic agent. In some embodiments, such a lipid increases the lipophilicity or other desirable property of the lipid prodrug, e.g. to increase lymphatic uptake and transport. In some embodiments, the lipid is conjugated to the therapeutic agent at an available at an available nitrogen, sulfur, or oxygen atom, such as a carboxylic acid, amine, hydroxyl, or amide. In some embodiments, the lipid is selected from those described below. In some embodiments, the lipid forms an ester of the therapeutic agent.

As used herein, depiction of brackets around a therapeutic agent, A, means that the

moiety is covalently attached to A at any available modifiable nitrogen, oxygen, or sulfur atom. For purposes of clarity and by way of example, such available modifiable nitrogen, oxygen, or sulfur atoms in the following therapeutic agent compound structure are depicted below, wherein each wavy bond defines the point of attachment to said

In certain embodiments, the present invention provides a compound of formula I, wherein L is

thereby forming a compound of formula II:

or a pharmaceutically acceptable salt thereof, wherein each of R¹, R², R⁴, X, M and A is as defined above and described in embodiments herein, both singly and in combination.

In certain embodiments, the present invention provides a compound of formula I, wherein L is

thereby forming a compound of formula III:

or a pharmaceutically acceptable salt thereof, wherein each of R¹, R², R⁴, R⁵, X, M and A is as defined above and described in embodiments herein, both singly and in combination.

In certain embodiments, the present invention provides a compound of formula I, wherein L is

and M is

thereby forming a compound of formula IV:

or a pharmaceutically acceptable salt thereof, wherein each of R¹, R², R⁴, R⁵, R⁶, X, and A is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula VI-a:

or a pharmaceutically acceptable salt thereof, wherein each of L, R², R, X, and A is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula VII-a or VII-b:

or a pharmaceutically acceptable salt thereof, wherein each of R¹, R², R⁴, R⁵, X, M, and A is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula VIII-a or VIII-b:

or a pharmaceutically acceptable salt thereof, wherein each of R¹, R², R⁴, R⁵, X, n, and A is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula IX-a, IX-b, IX-c, or IX-d:

or a pharmaceutically acceptable salt thereof, wherein each variable is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula X-a, X-b, X-c, X-d, X-e, X-f, X-g, or X-h:

or a pharmaceutically acceptable salt thereof, wherein each variable is as defined above and described in embodiments herein, both singly and in combination.

In some embodiments, the present invention provides a compound of Formula XI-a or XI-b:

or a pharmaceutically acceptable salt thereof, wherein each variable is as defined above and described in embodiments herein, both singly and in combination.

In the above formulae, when a range of numbers, such as 0-4 or 1-18, is disclosed, individual integers within the range are also specifically disclosed. Thus, the above range of 0-4 includes 0, 1, 2, 3, and 4. The range 1-18 includes 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 as well as ranges in between such as 6-18 and 8-18. The range 0-1 includes 0 and 1, i.e. the group is optionally present. Where more than one range is disclosed in a formula, each range is independently and optionally selected from the disclosed range. For example, in Formula X-c above, each 0-4 and 0-1 range is varied independently of the others.

In some embodiments, the lipid prodrug is one of those described in U.S. Ser. No. 62/724,274, filed on Aug. 29, 2018, the entirety of which is hereby incorporated by reference.

In some embodiments, the lipid prodrug is one of those described in U.S. Ser. No. 62/724,440, filed on Aug. 29, 2018, the entirety of which is hereby incorporated by reference.

In other embodiments, the present invention provides a compound of Formula V:

or a pharmaceutically acceptable salt thereof, wherein:

-   R¹ and R² are each independently hydrogen or —C(O)R³; -   each R³ is independently a saturated or unsaturated, straight or     branched C₂₋₃₇ hydrocarbon chain; -   X is —O—, —NR—, or —S—; -   each R is independently hydrogen or an optionally substituted C₁₋₄     aliphatic; -   L¹ is a covalent bond or a bivalent, saturated or unsaturated,     straight or branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene     units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—,     —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—,     —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—, wherein: -   each -Cy- is independently an optionally substituted 5-6 membered     bivalent aryl ring having 0-4 heteroatoms independently selected     from nitrogen, oxygen, or sulfur; and -   R⁷ is a moiety suitable for click chemistry or metal-free click     chemistry.

R¹, R², R³, X, R, and -Cy- are as defined above and described herein. Embodiments of R¹, R², R³, X, R, and -Cy- are as defined above and described herein.

As defined above and described herein, L¹ is a covalent bond or a bivalent, saturated or unsaturated, straight or branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—.

In some embodiments, L¹ is a covalent bond. In some embodiments, L¹ is a bivalent, saturated, straight C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—. In some embodiments, L¹ is a bivalent, saturated, branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—. In some embodiments, L¹ is a bivalent, unsaturated, straight C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—. In some embodiments, L¹ is a bivalent, unsaturated, branched C₁₋₂₀ hydrocarbon chain, wherein 0-6 methylene units of L¹ are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O)₂—, —NRS(O)₂—, —S(O)₂NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, or —NRC(O)O—.

In some embodiments, L¹ is selected from those depicted in Table A, below.

As defined above and described herein, R⁷ is a moiety suitable for click chemistry or metal-free click chemistry.

In some embodiments, R⁷ is a moiety suitable for click chemistry. In some embodiments, R⁷ is a moiety suitable for metal-free click chemistry.

In some embodiments, R⁷ is —N3. In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In some embodiments, R⁷ is

In one aspect, the present invention provides a lipid prodrug compound, or pharmaceutically acceptable salt thereof, shown in Table A:

TABLE A Exemplary Compounds

I-1

I-2

I-3

I-4

I-5

I-6

I-7

I-8

I-9

I-10

I-11

I-12

I-13

I-14

I-15

I-16

I-17

I-18

I-19

I-20

I-21

I-22

I-23

I-24

I-25

I-26

I-27

I-28

I-29

I-30

I-31

I-32

I-33

I-34

I-35

I-36

I-37

I-38

I-39

I-40

I-41

I-42

I-43

I-44

I-45

I-46

I-47

I-48

I-49

I-50

I-51

I-52

I-53

I-54

I-55

I-56

MPA- MPA- I-1

MPA- MPA- I-2

MPA- MPA- I-3

MPA- MPA- I-4

MPA- MPA- I-5

MPA- MPA- I-6

MPA- MPA- I-7

MPA- MPA- I-8

MPA- MPA- I-8′

MPA- MPA- I-9

MPA- MPA- I-10

MPA- MPA- I-11

MPA- MPA- I-12

MPA- MPA- I-13

MPA- MPA- I-14

MPA- MPA- I-15

MPA- MPA- I-16

MPA- MPA- I-17

MPA- MPA- I-18

MPA- MPA- I-19

MPA- MPA- I-20

MPA- MPA- I-21

MPA- MPA- I-22

MPA- MPA- I-23

MPA- MPA- I-24

MPA- MPA- I-25

MPA- MPA- I-26

MPA- MPA- I-27

MPA- MPA- I-28

MPA- MPA- I-29

MPA- I-30

MPA- I-31

MPA- I-32

MPA- I-33

MPA- I-34

MPA- I-35

MPA- I-36

MPA- I-37

MPA- I-38

MPA- I-39

MPA- I-40

MPA- I-41

MPA- I-42

MPA- I-43

MPA- I-44

MPA- I-45

MPA- I-46

MPA- I-47

MPA- I-48

MPA- I-49

MPA- I-50

MPA- I-51

MPA- I-52

MPA- I-53

MPA- I-54

TAC- I-1

TAC- I-2

TAC- I-3

TAC- I-4

TAC- I-5

TAC- I-6

TAC- I-7

TAC- I-8

TAC- I-9

TAC- I-10

TAC- I-11

TAC- I-12

TAC- I-13

TAC- I-14

TAC- I-15

TAC- I-16

TAC- I-17

TAC- I-18

TAC- I-19

TAC- I-20

TAC- I-21

TAC- I-22

TAC- I-23

TAC- I-24

TAC- I-25

TAC- I-26

TAC- I-27

TAC- I-28

TAC- I-29

Lipids, Including Fatty Acids, Phospholipids, Lipid-Processing Mimetics, and Mixtures Thereof for Use in Disclosed Lipid Prodrugs

Lipid prodrugs according to the present disclosure mimic the lipid processing that takes place in the human body. In some embodiments, a disclosed lipid prodrug comprises one or two lipids covalently bound to one or two of the hydroxyl groups of the glyceride-based group shown in, e.g. Formula I or VI.

In some embodiments, a disclosed lipid prodrug further comprises a lipid covalently bound to the therapeutic agent. In some embodiments, such a lipid increases the lipophilicity or other desirable property of the lipid prodrug, e.g. to increase lymphatic uptake and transport. In some embodiments, the lipid is conjugated to the therapeutic agent at an available nitrogen, sulfur, or oxygen atom, such as a carboxylic acid, amine, hydroxyl, or amide. In some embodiments, the lipid is selected from those described below. In some embodiments, the lipid forms an ester of the therapeutic agent.

A variety of lipids are suitable for use in lipid prodrugs of the present disclosure. In some embodiments, the lipid prodrug comprises a fatty acid, phosphatide, phospholipid, or analogue thereof (e.g. phophatidylcholine, lecithin, phosphatidylethanolamine, cephalin, or phosphatidylserine or analogue or portion thereof, such as a partially hydrolyzed portion thereof), or other lipid-processing mimetic (e.g., a group cleaved by lipases, other digestive enzymes, or other mechanisms in the GI tract that enables the lipid prodrug to mimic dietary lipid processing). In some embodiments, the fatty acid is a short-chain, medium-chain, or long-chain fatty acid. In some embodiments, the fatty acid is a saturated fatty acid. In some embodiments, the fatty acid is an unsaturated fatty acid. In some embodiments, the fatty acid is a monounsaturated fatty acid. In some embodiments, the fatty acid is a polyunsaturated fatty acid, such as an ω-3 (omega-3) or ω-6 (omega-6) fatty acid. In some embodiments, the lipid, e.g., fatty acid, has a C₂-C₆₀ chain. In some embodiments, the lipid, e.g., fatty acid, has a C₂-C₂₈ chain. In some embodiments, the lipid, e.g., fatty acid, has a C₂-C₄₀ chain. In some embodiments, the lipid, e.g., fatty acid, has a C₂-C₁₂ or C₄-C₁₂ chain. In some embodiments, the lipid, e.g., fatty acid, has a C₄-C₄₀ chain. In some embodiments, the lipid, e.g., fatty acid, has a C₄-C₄₀, C₂-C₃₈, C₂-C₃₆, C₂-C₃₄, C₂-C₃₂, C₂-C₃₀, C₄-C₃₀, C₂-C₂₈, C₄-C₂₈, C₂-C₂₆, C₄-C₂₆, C₂-C₂₄, C₄-C₂₄, C₆-C₂₄, C₈-C₂₄, C₁₀-C₂₄, C₂-C₂₂, C₄-C₂₂, C₆-C₂₂, C₈-C₂₂, C₁₀-C₂₂, C₂-C₂₀, C₄-C₂₀, C₆-C₂₀, C₈-C₂₀, C₁₀-C₂₀, C₂-C₁₈, C₄-C₁₈, C₆-C₁₈, C₈-C₁₈, C₁₀-C₁₈, C₁₂-C₁₈, C₁₄-C₁₈, C₁₆-C₁₈, C₂-C₁₆, C₄-C₁₆, C₆-C₁₆, C₈-C₁₆, C₁₀-C₁₆, C₁₂-C₁₆, C₁₄- C₁₆, C₂-C₁₅, C₄-C₁₅, C₆-C₁₅, C₈-C₁₅, C₉-C₁₅, C₁₀-C₁₅, C₁₁-C₁₅, C₁₂-C₁₅, C₁₃-C₁₅, C₂-C₁₄, C₄-C₁₄, C₆-C₁₄, C₈-C₁₄, C₉-C₁₄, C₁₀-C₁₄, C₁₁-C₁₄, C₁₂-C₁₄, C₂-C₁₃, C₄-C₁₃, C₆-C₁₃, C₇-C₁₃, C₈-C₁₃, C₉-C₁₃, C₁₀-C₁₃, C₁₀-C₁₃, C₁₁-C₁₃, C₂-C₁₂, C₄-C₁₂, C₆-C₁₂, C₇-C₁₂, C₈-C₁₂, C₉-C₁₂, C₁₀-C₁₂, C₂-C₁₁, C₄-C₁₁, C₆-C₁₁, C₇-C₁₁, C₈-C₁₁, C₉-C₁₁, C₂-C₁₀, C₂-C₉, C₄-C₉, C₂-C₈, C₄-C₈, C₂-C₇, C₄-C₇, C₂-C₆, or C₄- C₆, chain. In some embodiments, the lipid, e.g., fatty acid, has a C₂, C₃, C₄, C₅, C₆, C₇, C₈, C₉, C₁₀, C₁₁, C₁₂, C₁₃, C₁₄, C₁₅, C₁₆, C₁₇, C₁₈, C₁₉, C₂₀, C₂₁, C₂₂, C₂₃, C₂₄, C₂₅, C₂₆, C₂₇, C₂₈, C₂₉, C₃₀, C₃₁, C₃₂, C₃₃, C₃₄, C₃₅, C₃₆, C₃₇, C₃₈, C₃₉, C₄₀, C₄₁, C₄₂, C₄₃, C₄₄, C₄₅, C₄₆, C₄₇, C₄₈, C₄₉, C₅₀, C₅₁, C₅₂, C₅₃, C₅₄, C₅₅, C₅₆, C57, C₅₈, C₅₉, or C₆₀ chain. In some embodiments, the lipid prodrug comprises two fatty acids, each of which is independently selected from a fatty acid having a chain with any one of the foregoing ranges or numbers of carbon atoms. In some embodiments, one of the fatty acids is independently a fatty acid with a C₆-C₂₁ chain and one is independently a fatty acid with a C₁₂-C₃₆ chain. In some embodiments, each fatty acid independently has a chain of 11, 12, 13, 14, 15, 16, or 17 carbon atoms.

In some embodiments, the lipid prodrug comprises two lipids. In some embodiments, the two lipids, e.g. fatty acids, taken together have 6-80 carbon atoms (an equivalent carbon number (ECN) of 6-80). In some embodiments, the lipids, e.g., fatty acids, have an ECN of 6-80, 8-80, 10-80, 12-80, 14-80, 16-80, 18-80, 20-80, 22-80, 24-80, 26-80, 28-80, 30-80, 4-76, 6-76, 8-76, 10-76, 12-76, 14-76, 16-76, 18-76, 20-76, 22-76, 24-76, 26-76, 28-76, 30-76, 6-72, 8-72, 10-72, 12-72, 14-72, 16-72, 18-72, 20-72, 22-72, 24-72, 26-72, 28-72, 30-72, 6-68, 8-68, 10-68, 12-68, 14-68, 16-68, 18-68, 20-68, 22-68, 24-68, 26-68, 28-68, 30-68, 6-64, 8-64, 10-64, 12-64, 14-64, 16-64, 18-64, 20-64, 22-64, 24-64, 26-64, 28-64, 30-64, 6-60, 8-60, 10-60, 12-56, 14-56, 16-56, 18-56, 20-56, 22-56, 24-56, 26-56, 28-56, 30-56, 6-52, 8-52, 10-52, 12-52, 14-52, 16-52, 18-52, 20-52, 22-52, 24-52, 26-52, 28-52, 30-52, 6-48, 8-48, 10-48, 12-48, 14-48, 16-48, 18-48, 20-48, 22-48, 24-48, 26-48, 28-48, 30-48, 6-44, 8-44, 10-44, 12-44, 14-44, 16-44, 18-44, 20-44, 22-44, 24-44, 26-44, 28-44, 30-44, 6-40, 8-40, 10-40, 12-40, 14-40, 16-40, 18-40, 20-40, 22-40, 24-40, 26-40, 28-40, 30-40, 6-36, 8-36, 10-36, 12-36, 14-36, 16-36, 18-36, 20-36, 22-36, 24-36, 26-36, 28-36, 30-36, 6-32, 8-32, 10-32, 12-32, 14-32, 16-32, 18-32, 20-32, 22-32, 24-32, 26-32, 28-32, or 30-32.

Suitable fatty acids include saturated straight-chain fatty acids, saturated branched fatty acids, unsaturated fatty acids, hydroxy fatty acids, and polycarboxylic acids. In some embodiments, such fatty acids have up to 32 carbon atoms.

Examples of useful saturated straight-chain fatty acids include those having an even number of carbon atoms, such as butyric acid, caproic acid, caprylic acid, capric acid, lauric acid, myristic acid, palmitic acid, stearic acid, arachic acid, behenic acid, lignoceric acid, hexacosanoic acid, octacosanoic acid, triacontanoic acid and n-dotriacontanoic acid, and those having an odd number of carbon atoms, such as propionic acid, n-valeric acid, enanthic acid, pelargonic acid, hendecanoic acid, tridecanoic acid, pentadecanoic acid, heptadecanoic acid, nonadecanoic acid, heneicosanoic acid, tricosanoic acid, pentacosanoic acid, and heptacosanoic acid.

Examples of suitable saturated branched fatty acids include isobutyric acid, isocaproic acid, isocaprylic acid, isocapric acid, isolauric acid, 11-methyldodecanoic acid, isomyristic acid, 13-methyl-tetradecanoic acid, isopalmitic acid, 15-methyl-hexadecanoic acid, isostearic acid, 17-methyloctadecanoic acid, isoarachic acid, 19-methyl-eicosanoic acid, α-ethyl-hexanoic acid, α-hexyldecanoic acid, α-heptylundecanoic acid, 2-decyltetradecanoic acid, 2-undecyltetradecanoic acid, 2-decylpentadecanoic acid, 2-undecylpentadecanoic acid, and Fine oxocol 1800 acid (product of Nissan Chemical Industries, Ltd.). Suitable saturated odd-carbon branched fatty acids include anteiso fatty acids terminating with an isobutyl group, such as 6-methyl-octanoic acid, 8-methyl-decanoic acid, 10-methyl-dodecanoic acid, 12-methyl-tetradecanoic acid, 14-methyl-hexadecanoic acid, 16-methyl-octadecanoic acid, 18-methyl-eicosanoic acid, 20-methyl-docosanoic acid, 22-methyl-tetracosanoic acid, 24-methyl-hexacosanoic acid, and 26-methyloctacosanoic acid.

Examples of suitable unsaturated fatty acids include 4-decenoic acid, caproleic acid, 4-dodecenoic acid, 5-dodecenoic acid, lauroleic acid, 4-tetradecenoic acid, 5-tetradecenoic acid, 9-tetradecenoic acid, palmitoleic acid, 6-octadecenoic acid, oleic acid, 9-octadecenoic acid, 11-octadecenoic acid, 9-eicosenoic acid, cis-11-eicosenoic acid, cetoleic acid, 13-docosenoic acid, 15-tetracosenoic acid, 17-hexacosenoic acid, 6,9,12,15-hexadecatetraenoic acid, linoleic acid, linolenic acid, α-eleostearic acid, β-eleostearic acid, punicic acid, 6,9,12,15-octadecatetraenoic acid, parinaric acid, 5,8,11,14-eicosatetraenoic acid, 5,8,11,14,17-eicosapentaenoic acid, 7,10,13,16,19-docosapentaenoic acid, 4,7,10,13,16,19-docosahexaenoic acid, and the like.

Examples of suitable hydroxy fatty acids include α-hydroxylauric acid, α-hydroxymyristic acid, α-hydroxypalmitic acid, α-hydroxystearic acid, w-hydroxylauric acid, α-hydroxyarachic acid, 9-hydroxy-12-octadecenoic acid, ricinoleic acid, α-hydroxybehenic acid, 9-hydroxy-trans-10,12-octadecadienic acid, kamolenic acid, ipurolic acid, 9,10-dihydroxystearic acid, 12-hydroxystearic acid and the like.

Examples of suitable polycarboxylic acids include oxalic acid, malonic acid, succinic acid, glutaric acid, adipic acid, pimelic acid, suberic acid, azelaic acid, sebacic acid, D,L-malic acid, and the like.

In some embodiments, each fatty acid is independently selected from Propionic acid, Butyric acid, Valeric acid, Caproic acid, Enanthic acid, Caprylic acid, Pelargonic acid, Capric acid, Undecylic acid, Lauric acid, Tridecylic acid, Myristic acid, Pentadecylic acid, Palmitic acid, Margaric acid, Stearic acid, Nonadecylic acid, arachidic acid, Heneicosylic acid, Behenic acid, Tricosylic acid, Lignoceric acid, Pentacosylic acid, Cerotic acid, Heptacosylic acid, Montanic acid, Nonacosylic acid, Melissic acid, Henatriacontylic acid, Lacceroic acid, Psyllic acid, geddic acid, ceroplastic acid, hexatriacontylic acid, heptatriacontanoic acid, or octatriacontanoic acid.

In some embodiments, each fatty acid is independently selected from α-linolenic acid, stearidonic acid, eicosapentaenoic acid, docosahexaenoic acid, linoleic acid, gamma-linoleic acid, dihomo-gamma-linoleic acid, arachidonic acid, docosatetraenoic acid, palmitoleic acid, vaccenic acid, paullinic acid, oleic acid, elaidic acid, gondoic acid, eurcic acid, nervonic acid, mead acid, adrenic acid, bosseopentaenoic acid, ozubondo acid, sardine acid, herring acid, docosahexaenoic acid, or tetracosanolpentaenoic acid, or another monounsaturated or polyunsaturated fatty acid.

In some embodiments, one or both of the fatty acids is an essential fatty acid. In view of the beneficial health effects of certain essential fatty acids, the therapeutic benefits of disclosed lipid prodrugs may be increased by including such fatty acids in the lipid prodrug. In some embodiments, the essential fatty acid is an n-6 or n-3 essential fatty acid selected from the group consisting of linolenic acid, gamma-linolenic acid, dihomo-gamma-linolenic acid, arachidonic acid, adrenic acid, docosapentaenoic n-6 acid, alpha-linolenic acid, stearidonic acid, the 20:4n-3 acid, eicosapentaenoic acid, docosapentaenoic n-3 acid, or docosahexaenoic acid.

In some embodiments, each fatty acid is independently selected from all-cis-7,10,13-hexadecatrienoic acid, α-linolenic acid, stearidonic acid, eicosatrienoic acid, eicosatetraenoic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid, docosahexaenoic acid (DHA), tetracosapentaenoic acid, tetracosahexaenoic acid, or lipoic acid. In other embodiments, the fatty acid is selected from eicosapentaenoic acid, docosahexaenoic acid, or lipoic acid. Other examples of fatty acids include all-cis-7,10,13-hexadecatrienoic acid, α-linolenic acid (ALA or all-cis-9,12,15-octadecatrienoic acid), stearidonic acid (STD or all-cis-6,9,12,15-octadecatetraenoic acid), eicosatrienoic acid (ETE or all-cis-11,14,17-eicosatrienoic acid), eicosatetraenoic acid (ETA or all-cis-8,11,14,17-eicosatetraenoic acid), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA, clupanodonic acid or all-cis-7,10,13,16,19-docosapentaenoic acid), docosahexaenoic acid (DHA or all-cis-4,7,10,13,16,19-docosahexaenoic acid), tetracosapentaenoic acid (all-cis-9,12,15,18,21-docosahexaenoic acid), or tetracosahexaenoic acid (nisinic acid or all-cis-6,9,12,15,18,21-tetracosenoic acid). In some embodiments, the fatty acid is a medium-chain fatty acid such as lipoic acid.

Fatty acid chains differ greatly in the length of their chains and may be categorized aaccording to chain length, e.g. as short to very long.

Short-chain fatty acids (SCFA) are fatty acids with chains of about five or less carbons (e.g. butyric acid). In some embodiments, each of the fatty acids is independently a SCFA. In some embodiments, one of the fatty acids is independently a SCFA.

Medium-chain fatty acids (MCFA) include fatty acids with chains of about 6-12 carbons, which can form medium-chain triglycerides. In some embodiments, each of the fatty acids is independently a MCFA. In some embodiments, one of the fatty acids is independently a MCFA.

Long-chain fatty acids (LCFA) include fatty acids with chains of 13-21 carbons. In some embodiments, each of the fatty acids is independently a LCFA. In some embodiments, one of the fatty acids is independently a LCFA.

Very long chain fatty acids (VLCFA) include fatty acids with chains of 22 or more carbons, such as 22-60, 22-50, or 22-40 carbons. In some embodiments, each of the fatty acids is independently a VLCFA. In some embodiments, one of the fatty acids is independently a VLCFA.

In some embodiments, one of the fatty acids is independently a MCFA and one is independently a LCFA.

Use of Click Chemistry to Attach Therapeutic Agent to the Lymphatic Drug-Release Moiety

In some embodiments, the therapeutic agent is covalently attached to the lymphatic drug-release moiety (i.e., the remaining portion of the lipid prodrug besides the therapeutic agent) by the use of “click” chemistry. The term “click-ready group” refers to a chemical moiety capable of undergoing a click reaction, such as an azide or alkyne.

Click reactions tend to involve high-energy (“spring-loaded”) reagents with well-defined reaction coordinates that give rise to selective bond-forming events of wide scope. Examples include nucleophilic trapping of strained-ring electrophiles (epoxide, aziridines, aziridinium ions, episulfonium ions), certain carbonyl reactivity (e.g., the reaction between aldehydes and hydrazines or hydroxylamines), and several cycloaddition reactions. The azide-alkyne 1,3-dipolar cycloaddition and the Diels-Alder cycloaddition are two such reactions.

Such click reactions (i.e., dipolar cycloadditions) are associated with a high activation energy and therefore require heat or a catalyst. Indeed, use of a copper catalyst is routinely employed in click reactions. However, in certain instances where click chemistry is particularly useful (e.g., in bioconjugation reactions), the presence of copper can be detrimental (See Wolbers, F. et al.; Electrophoresis 2006, 27, 5073). Accordingly, methods of performing dipolar cycloaddition reactions were developed without the use of metal catalysis. Such “metal free” click reactions utilize activated moieties in order to facilitate cycloaddition. Therefore, the present invention provides click-ready groups suitable for metal-free click chemistry.

Certain metal-free click moieties are known in the literature. Examples include 4-dibenzocyclooctynol (DIBO)

(from Ning et al; Angew Chem Int Ed, 2008, 47, 2253); gem-difluorinated cyclooctynes (DIFO or DFO)

(from Codelli, et al.; J. Am. Chem. Soc. 2008, 130, 11486-11493.); biarylazacyclooctynone (BARAC)

(from Jewett et al.; J. Am. Chem. Soc. 2010, 132, 3688.); or bicyclononyne (BCN) (From Dommerholt, et al.; Angew Chem Int Ed, 2010, 49, 9422-9425).

As used herein, the phrase “a moiety suitable for metal-free click chemistry” refers to a functional group capable of dipolar cycloaddition without use of a metal catalyst. Such moieties include an activated alkyne (such as a strained cyclooctyne), an oxime (such as a nitrile oxide precursor), or oxanorbornadiene, for coupling to an azide to form a cycloaddition product (e.g., triazole or isoxazole).

Therapeutic Agents and Exemplary Associated Diseases

In accordance with the present invention, a variety of therapeutic agents may be covalently conjugated to the lymphatic system-directing lipids, e.g. triglyceride scaffolds, described herein. In some embodiments, by conjugating a therapeutic agent to a lymphatic system-directing lipid, the present invention enhances desirable properties of the therapeutic agent such as improving oral bioavailability, minimizing destruction of the agent in the gut, avoiding liver first-pass effect, improving therapeutic agent delivery to a target tissue, or increasing the solubility and stability of the therapeutic agents, including the solubility and stability of the agents in vivo.

The present invention provides a method of treating a disease, disorder, or condition in a patient in need thereof comprising administering to said patient a disclosed lipid prodrug. In some embodiments, a disclosed lipid prodrug is useful in treating a disease, disorder, or condition for which the parent therapeutic agent is known to be used. Furthermore, because of the improved delivery and other properties of the disclosed lipid prodrugs, in some embodiments, a disclosed lipid prodrug is useful also for treating or preventing a disease, disorder, or condition for which the parent therapeutic agent is not suitable because of insufficient lymphatic transport, undesired metabolism, off-target toxicity, or the like.

In one aspect, the present invention provides a lipid prodrug of an immunomodulatory therapeutic agent.

In some embodiments, the present invention provides a method of treating an autoimmune disease, disorder, or condition in a patient in need thereof comprising administering to the patient a disclosed lipid prodrug. In some embodiments, the autoimmune disease, disorder, or condition is selected from Behcet's disease, pemphigus vulgaris, refractory incomplete systemic lupus erythematosus, immunoglobulin A nephropathy, small vessel vasculitis, or psoriasis.

In some embodiments, the present invention provides a method of preventing organ transplant rejection in a patient in need thereof, comprising administering a disclosed lipid prodrug to a patient in need thereof.

In some embodiments, a disclosed lipid prodrug modulates the immune system of a patient after administration by increased exposure of the active agent to the lymphatic system of the patient. In some embodiments, a disclosed lipid prodrug is taken up selectively into the lymphatic system of the patient after oral administration. In some embodiments, once in the lymphatic system, the lipid prodrug interacts with immune cells in the lymphatic system. In some embodiments, a disclosed lipid prodrug is delivered selectively to B or T lymphocytes. In some embodiments, a disclosed lipid prodrug modulates the activity of B or T lymphocytes. In some embodiments, a disclosed lipid prodrug modulates the activity of one or more of B cells, dendritic cells, granulocytes, innate lymphoid cells (ILCs), megakaryocytes, monocytes/macrophages, myeloid-derived suppressor cells (MDSC), natural killer (NK) cells, platelets, red blood cells (RBCs), T cells, or thymocytes. In some embodiments, a disclosed lipid prodrug exhibits increased delivery at a given dose or more selective delivery at a given dose to B or T lymphocytes as compared with a corresponding dose of a non-lipid prodrug form of the active agent. In some embodiments, a given dose of a disclosed lipid prodrug more effectively modulates the activity of one or more of B cells, dendritic cells, granulocytes, innate lymphoid cells (ILCs), megakaryocytes, monocytes/macrophages, myeloid-derived suppressor cells (MDSC), natural killer (NK) cells, platelets, red blood cells (RBCs), T cells, or thymocytes, as compared with a corresponding dose of a non-lipid prodrug form of the parent therapeutic agent.

In some embodiments, the present invention provides a method of treating a disease, disorder, or condition in a patient in need thereof, comprising administering to the patient a disclosed lipid prodrug, or a pharmaceutically acceptable salt thereof, wherein the disease, disorder, or condition is selected from Inflammatory disease, Abdominal cavity inflammation, Peritonitis, Mesenteritis, Perihepatitis, Salpingoperitonitis, Autoinflammatory disease, Cryopyrin associated periodic syndrome, CINCA syndrome, Familial cold autoinflammatory syndrome, Muckle Wells syndrome, Cardiovascular inflammation, Carditis, Endocarditis, Bacterial endocarditis, Infectious endocarditis, Non infectious endocarditis, Thromboendocarditis, Pericarditis, Chylopericarditis, Dressler syndrome, Pleuropericarditis, Vasculitis, Arteritis, Aortitis, Takayasus arteritis, Endarteritis, HIV associated arteritis, Kawasaki disease, Periarteritis, Polyarteritis nodosa, Temporal arteritis, Extracranial temporal arteritis, Intracranial temporal arteritis, Churg-Strauss syndrome, Cutaneous vasculitis, Perivasculitis, Phlebitis, Lymphangiophlebitis, Thrombophlebitis, Mondor disease, Thromboangiitis, Thromboangiitis obliterans, Thrombophlebitis, Mondor disease, Dermatitis, Acrodermatitis, Angiodermatitis, Drug eruption, Erythema multiforme, Serum sickness, Stevens Johnson syndrome, Toxic epidermal necrolysis, Intertrigo, Skin allergy, Atopic dermatitis, Contact dermatitis, Eczema, Fibrosis, Cicatrix, Tissue adhesions, Pulmonary fibrosis, Idiopathic pulmonary fibrosis, Renal fibrosis, Gastrointestinal inflammation, Anusitis, Biliary tract inflammation, Hepatocholangitis, Cholecystiti s, Esophagiti s, Eosinophilic esophagiti s, Gastriti s, Gastroduodeniti s, Gastroenteriti s, Hypertrophic gastritis, Hepatitis, Enterohepatitis, Hepatitis virus infection, Hepatitis A virus infection, Hepatitis B virus infection, Hepatitis C virus infection, Hepatitis D virus infection, Hepatitis E virus infection, Hepatitis F virus infection, Hepatitis G virus infection, Hepatocholangitis, Non-viral hepatitis, Alcoholic hepatitis, Autoimmune hepatitis, Perihepatitis, Steatohepatitis, Non-alcoholic steatohepatitis, Inflammatory bowel disease, Colitis, Diverticulitis, Meckel's diverticulitis, Enterocolitis, Acute enterocolitis, Necrotizing enterocolitis, Ileocecitis, Pseudomembranous colitis, Sigmoiditis, Rectosigmoiditis, Ulcerative colitis, Crohns disease, Enteritis, Enterocolitis, Acute enterocolitis, Necrotizing enterocolitis, Enterohepatitis, Hemorrhagic enteritis, Ileitis, Ileocecitis, Pouchitis, Jejunitis, Mucositis, Pancreatitis, Balser necrosis, Necrotizing acute pancreatitis, Peritonitis, Mesenteritis, Perihepatitis, Salpingoperitonitis, Proctitis, Rectosigmoiditis, Ulcerative proctitis, Genitourinary tract inflammation, Genital tract inflammation, Female genital tract inflammation, Endometriosis, Parametritis, Pelvic inflammatory disease, Salpingitis, Vaginitis, Atrophic vaginitis, Bartholinitis, Vulvovaginitis, Vulvitis, Vulvovaginitis, Male genital tract inflammation, Balanitis, Epididymitis, Epididymo-orchiti s, Orchiti s, Epididymo-orchiti s, Periorchiti s, Prostatitis, Urinary tract inflammation, Nephritis, Alport syndrome, Glomerulonephritis, Focal segmental glomerulosclerosi s, IgA nephropathy, Membranoproliferative glomerulonephritis, Membranous glomerulonephritis, Wegener granulomatosis, Lupus nephritis, Pyelitis, Pyelocystitis, Pyelonephriti s, Granulomatosi s, Allergic granulomatosis, Sarcoidosis, Wegener granulomatosi s, Mastitis, Mouth inflammation, Gingivitis, Pericoroniti s, Pharyngiti s, Rhinopharyngiti s, Sialadenitis, Musculoskeletal system inflammation, Arthritis, Behcets disease, Chondrocalcinosis, Gout, Infectious arthritis, Osteoarthritis, Periarthritis, Psoriatic arthritis, Reiter syndrome, Rheumatoid arthritis, Adult onset Stills disease, Felty syndrome, Juvenile rheumatoid arthritis, Bursitis, Dactylitis, Myositis, Dermatomyositis, Inclusion body myositis, Hereditary inclusion body myositis, Sporadic inclusion body myositis, Polymyositis, Pyomyositis, Nervous system inflammation, Meningitis, Arachnoiditi s, Aseptic meningitis, Infectious meningitis, Bacterial meningitis, Neisseria meningitidis meningitis, Fungal meningitis, Cryptococcus neoformans meningitis, Parasitic meningitis, Viral meningitis, Neoplastic meningitis, Pachymeningitis, Neuritis, Neuromyelitis optica, Poliovirus infection, Postpoliomyelitis syndrome, Ocular and orbital inflammation, Ocular inflammation, Chorioretinitis, Conjunctivitis, Allergic conjunctivitis, Blepharoconjunctivitis, Keratoconjunctivitis, Infectious keratoconjunctivitis, Ophthalmia neonatorum, Trachoma, Uveitis, Intermediate uveitis, Pars planitis, Orbital inflammatory disease, Idiopathic orbital inflammation, Respiratory tract inflammation, Lower respiratory tract inflammation, Bronchitis, Lung inflammation, Asthma, Asthma attack, Exercise induced asthma, Nocturnal asthma, Occupational asthma, Status asthmaticus, Pleurisy, Upper respiratory tract inflammation, Pharyngiti s, Rhinopharyngiti s, Rhinitis, Allergic rhiniti s, Perennial allergic rhiniti s, Seasonal allergic rhinitis, Rhinopharyngitis, Sinusitis, Acute sinusitis, Chronic sinusitis, Ethmoiditis, Kartagener syndrome, Pansinusitis, Serositis, Familial mediterranean fever, Systemic inflammatory response syndrome, Immune disorder, Allergy, Delayed hypersensitivity, Contact dermatitis, Hypersensitivity, Immediate hypersensitivity, Food hypersensitivity, Egg hypersensitivity, Milk hypersensitivity, Oral allergy syndrome, Peanut hypersensitivity, Wheat hypersensitivity, Fungal allergy, Immune complex disease, Arthus reaction, Immediate type hypersensitivity, Atopic dermatitis, Respiratory tract allergy, Allergic rhinitis, Perennial allergic rhinitis, Seasonal allergic rhinitis, Asthma, Asthma attack, Exercise induced asthma, Nocturnal asthma, Occupational asthma, Status asthmaticus, Skin allergy, Atopic dermatitis, Contact dermatitis, Eczema, Autoimmune disease, Antiphospholipid syndrome, Autoimmune hemolytic anemia, Cold agglutinin disease, Autoimmune hepatitis, Autoimmune nervous system disease, Autoimmune demyelinating nervous system disease, Stiff person syndrome, Lambert-Eaton syndrome, Behcets disease, Crohns disease, Cutaneous lupus erythematosus, Discoid lupus erythematosus, Evans syndrome, Goodpasture syndrome, Graves disease, Guillain Barre syndrome, Hashimotos disease, Henoch Schonlein purpura, Lupus nephritis, Multiple sclerosis, Myasthenia gravis, Paroxysmal nocturnal hemoglobinuria, Primary biliary cirrhosis, Psoriasis, Parapsoriasis, Psoriatic arthritis, Rheumatoid arthritis, Adult onset Stills disease, Felty syndrome, Juvenile rheumatoid arthritis, Sjoegrens syndrome, Systemic lupus erythematosus, Temporal arteritis, Extracranial temporal arteritis, Intracranial temporal arteritis, Ulcerative colitis, Vitiligo, Non segmental vitiligo, Segmental vitiligo, Wegener granulomatosis, Graft versus host disease, Transplant rejection, Bone marrow transplant rejection, Cell transplant rejection, Corneal transplant rejection, Heart transplant rejection, Kidney transplant rejection, Liver transplant rejection, Lung transplant rejection, Organ transplant rejection, Intestine transplantation, Large intestine transplantation, Small intestine transplantation, Pancreas transplant rejection, Islet cell transplant rejection, Skin transplant rejection, Tissue transplant rejection, Immune deficiency, Agammaglobulinemia, Brutons disease, Combined immunodeficiency, Acquired immune deficiency syndrome, AIDS related complex, Nezelof syndrome, Severe combined immunodeficiency syndrome, Adenosine deaminase deficiency, Common variable immunodeficiency, DiGeorge syndrome, Dysgammaglobulinemia, Immunoglobulin A deficiency, Immunoglobulin G deficiency, Phagocyte bactericidal disorder, Chediak Higashi syndrome, Chronic granulomatous disease, Job syndrome, Wiskott-Aldrich syndrome, Immunoadsorption, Lymphatic system disease, Adenoid disease, Adenoid hypertrophy, Adenoid tumor, Adenoiditis, Lymphadenopathy, Kawasaki disease, Lymphadenitis, Lymphangiophlebitis, Lymphangitis, Lymphatic system tumor, Adenoid tumor, Castleman's disease, Lymphangioma, Cystic hygroma, or Lymphangiomyoma.

In some embodiments, the autoimmune disease, disorder, or condition is selected from Behcet's disease, pemphigus vulgaris, refractory incomplete systemic lupus erythematosus, retroperitoneal fibrosis, idiopathic thrombocytopenic purpura (ITP), scleroderma (systemic sclerosis or SSc), pemphigus vulgaris, granulomatosis with polyangiitis, immunoglobulin A nephropathy, small vessel vasculitis, retroperitoneal fibrosis, and psoriasis.

In some embodiments, the present invention provides a method of treating or preventing organ transplant rejection, graft-versus-host disease, or implant rejection, comprising administering to a patient in need thereof an effective amount of a disclosed lipid prodrug. In some embodiments, the organ transplant is selected from a skin, liver, heart, kidney, pancreas, thymus, small intestine, large intestine, uterus, a vascularized composite allograft (VCA) such as face or hand, bone marrow, allogenic blood and marrow transplant (BMT), cornea, and lung transplant. In some embodiments, the organ transplant rejection is acute or chronic transplant rejection.

In some embodiments, the present invention provides a lipid prodrug for use in the treatment or prevention of a disease or disorder in which increased testosterone levels are beneficial, or a disease or disorder caused by a testosterone deficiency. Such diseases and disorders include, but are not limited to, hypogonadism, anemia due to bone marrow failure, anemia due to renal failure, chronic respiratory failure, chronic cardiac failure, steroid-dependent autoimmune disorders, AIDS wasting, hereditary angioedema or urticaria, terminal breast cancer, or menopause.

In some embodiments, the present invention provides a method of modulating an immune response, comprising administering to a patient in need thereof an effective amount of a disclosed lipid prodrug that comprises an immunomodulatory therapeutic agent. In some embodiments, the immune response includes one or more immune responses mediated by the lymphatic system, or mediated by immune cells in the lymphatic system. In some embodiments, the patient is suffering from a hyperproliferative disease, disorder, or condition such as cancer. In some embodiments, the patient is suffering from an autoimmune disease, disorder, or condition.

Various therapeutic agents are suitable for use in the present invention. Examples of suitable therapeutic agents include, but are not limited to, testosterone, mycophenolic acid (MPA), buprenorphine, oestrogens (estrogen), opiates such as morphine, tetrahydrocannabinol (THC), cannabidiol, metoprolol, raloxifene, alphaxolone, statins such as atorvastatin, pentazocine, propranolol, L-DOPA, lidocaine, chlorpromazine, sertraline, amitriptyline, nortriptyline, pentazocine, glyceryl trinitrate, oxprenolol, labetalol, salbutamol, epitiostanol, melphalan, lovastatin, non-steroidal antiinflammatory medications (NSAIDS, such as aspirin, ibuprofen, and naproxen), COX-2 inhibitors (such as celecoxib), corticosteroid anti-inflammatory medications (such as prednisolone, prednisone, or dexamethasone), anti-malarial medications (such as hydroxychloroquine), nitrosoureas, methotrexate, dactinomycin, anthracyclines (such as daunorubicin), mitomycin C, bleomycin, mithramycin, drugs acting on immunophilins (such as cyclosporin, tacrolimus, sirolimus), sulfasalazine, leflunomide, mycophenolate, opioids, fingolimod, myriocin, chlorambucil, doxorubicin, nelarabine, cortisone, dexamethasone, prednisone, pralatrexate, vinblastine, bortezomib, nelarabine, daunorubicin hydrochloride, clofarabine, cytarabine, dasatinib, imatinibmesylate, ponatinib hydrochloride, vincristine sulfate, bendamustine hydrochloride, fludarabine phosphate, bosutinib, nilotinib, omacetaxine mepesuccinate, capecitabine, paclitaxel, gemcitabine, fulvestrant, tamoxifen, lapatinib, toremifene, ixabepilone, eribulin, albendazole, ivermectin, diethylcarbamazine, albendazole, doxycycline, closantel, maraviroc, enfuvirtide, deoxythymidine, zidovudine, stavudine, didanosine, zalcitabine, abacavir, lamivudine, emtricitabine, tenofovir, delavirdine, rilpivirine, raltegravir, elvitegravir, lopinavir, indinavir, nelfinavir, amprenavir, ritonavir, or acyclovir, or a pharmaceutically acceptable salt thereof.

In some embodiments, the therapeutic agent is an NSAID or pharmaceutically acceptable salt thereof. Exemplary NSAIDs fall into a number of categories, including: 1) salicylates and various derivatives thereof, including acetyl salicylic acid, salicylic acid, methyl salicylate, diflunisal, and salsalate; 2) the pyrazolone derivatives, including phenylbutazone, oxyphenbutazone, antipyrine, aminopyrine, dipyrone, and apazone; 3) the para-aminophenol derivatives, including acetaminophen (paracetamol), phenacetin and related compounds; 4) indomethacin, sulindac and related compounds; 5) the fenamates, including; mefenamic, meclofenamic, flufenamic, tolfenamic, and etofenamic acids, and related compounds; 6) the proprionic acid derivatives including ibuprofen, naproxen, fenoprofen, ketoprofen, flurbiprofen and related compounds; 7) the oxicam derivatives such as piroxicam and related compounds; 8) the phenylacetic acid derivatives such as diclofenac and related compounds; and 9) other NSAIDs such as tolmetin, etodolac and nabumetone.

In some embodiments, the NSAID is selected from acetyl salicylic acid, salicylic acid, methyl salicylate, diflunisal, salsalate, phenylbutazone, oxyphenbutazone, antipyrine, aminopyrine, dipyrone, apozone, acetaminophen, phenacetin, indomethacin, sulindac, mefenamic, meclofenamic, flufenamic, tolfenamic, etofenamic acid, ibuprofen, naproxen, fenoprofen, ketoprofen, flurbiprofen, prioxicam, diclofenac, tolmetin, etodolac, or nabumetone.

In some embodiments, the therapeutic agent is a 5-amino salicylate (5-ASA) compound, sulfasalazine, balsalazide, or olsalazine.

Examples of suitable imaging agents include, but are not limited to, fluorophores such as the Alexa Fluor series of optical imaging probes for fluorescence microscopy or where the fluorophore has emission spectra in the infra-red range, for in vivo imaging; gamma emitters that can be used for positron emission tomography (PET), such as fluorodeoxyglucose, or chelating agents in order to chelate magnetic resonance imaging probes such as gadolinium or iron.

In some embodiments, the therapeutic agent is selected from non-steroidal anti-inflammatory medications (NSAIDS, such as aspirin, ibuprofen, or naproxen), COX-2 inhibitors (such as celecoxib), corticosteroid anti-inflammatory medications (such as prednisolone, or dexamethasone), anti-malarial medications (such as hydroxychloroquine), cyclophosphamide, PPAR agonists (such as the fibrates), nitrosoureas, platinum, methotrexate, azathioprine, mercaptopurine, fluorouracil, dactinomycin, anthracyclines, mitomycin C, bleomycin, mithramycin, drugs acting on immunophilins (such as ciclosporin, tacrolimus, or sirolimus), sulfasalazine, leflunomide, mycophenolate, opioids, fingolimod, myriocin, chlorambucil, doxorubicin, nelarabine, cortisone, pralatrexate, vinblastine, bortezomib, thiotepa, nelarabine, daunorubicin hydrochloride, clofarabine, cytarabine, dasatinib, imatinibmesylate, ponatinib hydrochloride, vincristine sulfate, bendamustine hydrochloride, fludarabine phosphate, bosutinib, nilotinib, omacetaxine, mepesuccinate, anastrozole, capecitabine, letrozole, paclitaxel, gemcitabine, fulvestrant, tamoxifen, lapatinib, toremifene, ixabepilone, eribulin, albendazole, ivermectin, diethylcarbamazine, doxycycline, closantel, maraviroc, enfuvirtide, deoxythymidine, zidovudine, stavudine, didanosine, zalcitabine, abacavir, lamivudine, emtricitabine, tenofovir, nevirapine, delavirdine, efavirenz, rilpivirine, raltegravir, elvitegravir, lopinavir, indinavir, nelfinavir, amprenavir, ritonavir, acyclovir and immunosuppressants such as mycophenolic acid, cyclosporine, tacrolimus, or sirolimus.

In some embodiments, the therapeutic agent is selected from acetaminophen, buprenorphine, rivastigmine, allopregnanolone (for use in treating, e.g., post-partum depression, Niemann-Pick disease, or Status Epilecticus), brivarectam, tegretol, levetiracetam or brivaracetam or other anticonvulsant (for use in treating, e.g., epilepsy and/or as an anticonvulsant), fosphenytoin, propranolol, tenofivir, a small-molecule chemotherapeutic agent for treating lymphoma, an analgesic such as an NSAID, an oral contraceptive, a therapeutic agent for treating a parasitic disease, a mercaptopurine such as azathioprine or 6-mercaptopurine (for treating inflammatory bowel disease), a corticosteroid, silymarin, paclitaxel, oxaliplatin, docetaxel, gemcitabine, irinotecan, zoledronic acid or other bisphosphonate anticancer agent, cladribine, pralatrexate, romidepsin, bexarotene, bortezomib, bendamustine, chlormethine, nelarabine, belinostat, prednisolone, cyclophosphamide, guperimus, dexanabinol, mitoxantrone, verteporfin, methotrexate, fosbretabulin, pentostatin, or dexamethasone.

In one embodiment, the therapeutic agent is testosterone or a derivative or analogue thereof. Testosterone replacement therapy (TRT) is commonly used for patients with hypogonadism (a disorder characterised by abnormally low serum testosterone levels) to restore their serum testosterone levels to the normal range and thus relieve many of the symptoms of hypogonadism such as mood disturbance and sexual dysfunction.

In some embodiments, the therapeutic agent is a proteasome inhibitor such as bortezomib, carfilzomib, KZR-616, delanzomib, marizomib, ixazomib, LC-530110, TP-110, FV-214, FV-162, or the like.

In some embodiments, the therapeutic agent is a BTK inhibitor such as ibrutinib, ONO-WG-307, ML-319, ZYBT-1, X-022, spebrutinib, or the like.

In some embodiments, the therapeutic agent is a ROR-γt inhibitor or modulator. Exemplary ROR-γt inhibitors and modulators include LYC-55716, digoxin, ursolic acid, SR2211, ML 209, TMP778, TMP920, GSK805, ARN-6039, GNE-3500, MRL-299, JTE-151, VTP-43742, and compounds disclosed in WO2015116904, which is hereby incorporated by reference; see, e.g. Bioorganic & Medicinal Chemistry Letters, Volume 26, Issue 18, 15 Sep. 2016, Pages 4387-4393, hereby incorporated by reference.

In some embodiments, the therapeutic agent is selected from an immunomodulatory imide drug (IMiD) such as thalidomide, lenalidomide, pomalidomide, or apremilast.

In some embodiments, the therapeutic agent is selected from purine synthesis inhibitors (e.g. Azathioprine, Mycophenolic acid), pyrimidine synthesis inhibitors (Leflunomide, Teriflunomide), antifolate (Methotrexate), Macrolides/other IL-2 inhibitors, FKBP/Cyclophilin/Calcineurin (Tacrolimus, Ciclosporin, Pimecrolimus) Abetimus, or Gusperimus.

In some embodiments, the immunomodulatory therapeutic agent is selected from thalidomide, lenalidomide, pomalidomide, apremilast, azathioprine, mycophenolic acid, leflunomide, teriflunomide, methotrexate, a macrolide IL-2 inhibitor, tacrolimus, sirolimus (Rapamune®), everolimus (Certican™), CCI-779, ABT578, temsirolimus, TAFA-93, vistusertib, ciclosporin, pimecrolimus, abetimus, or gusperimus.

In some embodiments, the therapeutic agent is one of those in Table 1, below; or a pharmaceutically acceptable salt thereof.

TABLE 1 Exemplary Therapeutic Agents and Associated Diseases and Disorders Abbreviated Mechanism Of Drug Name Drug Name Indication Action abacavir abacavir HIV-1 Infection, HIV-2 Infection Acetylcysteine Acetylcysteine Antioxidants, Free injection - radical inhibitors Acitretin Acitretin Psoriasis, Dermatitis, Cancer Retinoic acid receptor agonists acyclovir acyclovir Herpes Labialis (Oral Herpes), Genital Herpes, Herpes Simplex Virus (HSV) Infections, Varicella Zoster (HHV-3) Infections, Herpes Zoster (Shingles), Fever Blisters, Chicken Pox Adefovir Adefovir HIV infections, Cancer, Hepatitis B, DNA-directed DNA Rheumatic disorders, Graft-versus- polymerase inhibitors, host disease Cell differentiation stimulants, Immunomodulators, Immunosuppressants Adefovir Adefovir Hepatitis B, HIV infections, Rheumatic DNA-directed DNA dipivoxil dipivoxil disorders polymerase inhibitors, Hepatitis B virus replication inhibitors, Nucleotide reverse transcriptase inhibitors Alatrofloxacin Alatrofloxacin Albendazole Albendazole Helminthic Infestations, Cysticercosis Tubulin inhibitors, (Taeniasis), Giardiasis, Nematodal Vascular endothelial (Round Worm) Infections, Tape Worm growth factors Infections, Ascariasis, Alveolar inhibitors Echinococcosis (Alveolar Hydatid Disease), Ancylostomiasis (Hookworm Infections), Cystic Echinococcosis (Alveolar Hydatid Disease), Echinococcosis (Hydatid Disease), Neurocysticercosis, Strongyloidiasis, Trichuriasis albuterol sulfate albuterol sulfate Asthma, Bronchospasm, Obstructive Beta 2 Adrenergic Pulmonary Disease, Chronic Receptor (Beta 2 Obstructive Pulmonary Disease Adrenoreceptor or (COPD), Chronic ADRB2) Agonist Bronchitis, Emphysema, Exercise- Induced Bronchoconstriction (EBI), Premature Labor (Tocolysis), Pulmonary Tuberculosis, Status Asthmaticus Alendronic acid Alendronic acid Postmenopausal osteoporosis, Male Osteoclast inhibitors osteoporosis, Fracture, Osteitis deformans, Osteoporosis, Corticosteroid-induced osteoporosis, Malignant hypercalcaemia, Bone resorption Alitretinoin Alitretinoin Alitretinoin Alitretinoin oral Acute promyelocytic leukaemia, Retinoic acid receptor Multiple myeloma, Ovarian cancer, agonists, Retinoid X Psoriasis, Non-Hodgkin's lymphoma, receptor agonists, Lung cancer, Preleukaemia, Renal Protein synthesis cancer, Cancer, Retinal disorders, inhibitors, Retinoic Prostate cancer, Kaposi's sarcoma, acid receptor Head and neck cancer antagonists Alovudine Alovudine HIV infections Nucleoside reverse transcriptase inhibitors Ambrisentan Ambrisentan Amifloxacin Amifloxacin Gram-negative infections, Septic Type II DNA shock, Urinary tract infections topoisomerase inhibitors Amifostine Amifostine Aminolevulinic Aminolevulinic Actinic keratosis, Brain cancer, Warts, Photosensitisers acid acid Barrett's oesophagus, Photodamage, Skin cancer, Acne vulgaris, Oesophageal cancer, Leucoplakia, Psoriasis Aminopterin Aminopterin Leukaemia, Endometrial cancer Antimetabolites, Tetrahydrofolate dehydrogenase inhibitors Aminosalicylic Aminosalicylic acid acid Amiodarone Amiodarone Cosolvent-free Amisulpride Amisulpride Dopamine D2 receptor antagonists, Dopamine D3 receptor antagonists amitriptyline amitriptyline Anxiety Disorders, Depression amprenavir amprenavir HIV-1 Infection Anagrelide Anagrelide anastrozole anastrozole Breast Cancer, Metastatic Breast Cancer, Hormone Sensitive Breast Cancer Aphidicolin Aphidicolin Cancer, Herpesvirus infections DNA-directed DNA polymerase inhibitors Apomorphine Apomorphine Dopamine D2 receptor agonists apremilast apremilast Psoriatic Arthritis, Plaque Psoriasis Phosphodiesterase 4 (Psoriasis Vulgaris) (PDE4 or EC 3.1.4.53) Inhibitor Arbutamine Arbutamine Argatroban Argatroban aripiprazole aripiprazole aspirin aspirin Cardiovascular Disease, Angina (Angina Pectoris), Myocardial Infarction, Migraine, Pain, Post- Operative Pain, Osteoarthritis Pain, Dysmenorrhea, Stroke, Cerebral Infarction (Brain Infarction), Back Pain, Pharyngitis, Gouty Arthritis (Gout), Nasopharyngitis (Common Cold), Unstable Angina, Ankylosing Spondylitis (Bekhterev's Disease), Ischemic Cerebral Stroke, Ischemic Stroke, Ischemia, Bronchitis, Arthritis Pain, Cardiovascular Risk Factors, Cerebrovascular Disease, Chronic Stable Angina, Dental Pain, Infectious Fever, Joint Pain, Low Back Pain, Mild Pain, Moderate Pain, Musculoskeletal Pain, Neuralgia, Rheumatoid Arthritis Pain, Sciatic Pain, Stable Angina, Tension -Type Headache, Thromboembolism Atazanavir/ Atazanavir/ HIV-1 infections Cytochrome P 450 cobicistat cobicistat enzyme system inhibitors, HIV protease inhibitors Atorvastatin Atorvastatin Hyperlipoproteinaemia type IIa, HMG-CoA reductase Hypercholesterolaemia, Low HDL inhibitors cholesterol, Hypertriglyceridaemia, Cardiovascular disorders, Heart failure, Hyperlipoproteinaemia type III, Alzheimer's disease, Neurological disorders Atovaquone Atovaquone Avibactam/ Avibactam/ ceftazidime ceftazidime Azacitidine Azacitidine Antimetabolites, DNA methylation inhibitors azathioprine azathioprine Liver Transplantation, Heart Transplantation, Polymyositis, Idiopathic Thrombocytopenic Purpura (Immune Thrombocytopenic Purpura), Dermatomyositis, Ulcerative Colitis, Transplantation, Rheumatoid Arthritis, Crohn's Disease (Regional Enteritis), Systemic Lupus Erythematosus, Kidney Transplantation, Acquired (Autoimmune) Hemolytic Anemia, Arteritis, Autoimmune Hepatitis, Pemphigus Vulgaris Azithromycin Azithromycin antibiotic Protein synthesis inhibitor Aztreonam Aztreonam Baclofen Baclofen Balsalazide Balsalazide disodium Bedaquiline Bedaquiline Belinostat Belinostat bendamustine bendamustine Anaplastic Astrocytoma, Glioblastoma hydrochloride Multiforme (GBM), Non-Hodgkin Lymphoma, Diffuse Large B-Cell Lymphoma, High Grade Non-Hodgkin Lymphoma, High-Grade Glioma, Indolent Lymphoma, Intermidiate Non- Hodgkin Lymphoma, Mantle Cell Lymphoma, Refractory Multiple Myeloma, Relapsed Multiple Myeloma Benzoate and Benzoate and phenylacetate phenylacetate Betaine Betaine Bexarotene Bexarotene oral Cutaneous T cell lymphoma, Non- Peroxisome small cell lung cancer, Thyroid cancer proliferator-activated receptor agonists, Protein synthesis inhibitors, Retinoid X receptor agonists Biapenem Biapenem Bacterial infections Cell wall inhibitors Bicalutamide Bicalutamide Prostate cancer Testosterone congener inhibitors Bortezomib Bortezomib Mantle-cell lymphoma; Multiple Apoptosis stimulants, myeloma Proteasome inhibitors, Immunomodulators Bosentan Bosentan Skin ulcer, Pulmonary arterial Endothelin A receptor hypertension, Diabetic foot ulcer, antagonists, Pulmonary fibrosis, Heart failure, Endothelin B receptor Malignant melanoma, Asthma, antagonists Ischaemic heart disorders, Transplant rejection, Inflammatory bowel diseases, Kidney disorders, Myocardial infarction, Reperfusion injury bosutinib Bosutinib Bile Duct Cancer (Cholangiocarcinoma), Colorectal Cancer, Polycystic Kidney Disease, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Pancreatic Cancer, Metastatic Breast Cancer, Recurrent Glioblastoma Multiforme (GBM) Bromfenac Bromfenac Ocular inflammation, Ocular pain, Age- Cyclooxygenase related macular degeneration, inhibitors Postoperative pain, Osteoarthritis, Dry eyes, Dysmenorrhoea Bropirimine Bropirimine Bladder cancer, Lymphoma, Herpes Interferon alpha simplex virus infections stimulants Broxuridine Broxuridine Breast cancer, Brain cancer Antimetabolites, DNA modulators Buprenorphine Buprenorphine Neuropathic Pain, Pain, Cancer Pain, Nociceptin receptor transdermal Chronic Pain, Post-Operative Pain, agonists, Opioid delta Osteoarthritis Pain, Back Pain, receptor antagonists, Fibromyalgia, Diabetic Neuropathic Opioid kappa receptor Pain, Low Back Pain, Moderate Pain, antagonists, Opioid Musculoskeletal Pain, Rheumatoid mu receptor agonists Arthritis Pain, Opium addiction Bupropion Bupropion Seasonal affective disorder, Major Adrenergic receptor depressive disorder, Smoking antagonists, withdrawal, Obesity, Social phobia, Dopamine uptake Post-traumatic stress disorders inhibitors Cabazitaxel Cabazitaxel Cabozantinib Cabozantinib Calcitonin Calcitonin human for injection Calcium Calcium levofolinate levofolinate Cangrelor Cangrelor capecitabine capecitabine Breast Cancer, Esophageal Cancer, Colorectal Cancer, Gastric Cancer, Metastatic Breast Cancer, Colon Cancer, Metastatic Colorectal Cancer Capsaicin Capsaicin TRPV1 receptor dermal patch agonists, Substance P inhibitors Carfilzomib Carfilzomib Refractory Multiple Myeloma, Proteasome inhibitors Relapsed Multiple Myeloma Carvedilol Carvedilol Hypertension, Heart failure, Angina Alpha 1 adrenergic pectoris, Atrial fibrillation, Myocardial receptor antagonists, infarction, Post-traumatic stress Beta-adrenergic disorders, Reperfusion injury, receptor antagonists, Arrhythmias, Ischaemic heart disorders Calcium channel antagonists, Antioxidants Cefepime Cefepime Ceftaroline Ceftaroline fosamil fosamil Ceftazidime Ceftazidime Cell wall inhibitors Ceftibuten Ceftibuten Otorhinolaryngological infections, Cell wall inhibitors Bacterial infections, Respiratory tract infections Ceftolozane/ Ceftolozane/ tazobactam tazobactam celecoxib celecoxib Acute Pain, Post-Operative Pain, Osteoarthritis Pain, Juvenile Rheumatoid Arthritis, Back Pain, Ankylosing Spondylitis (Bekhterev's Disease), Dental Pain, Familial Adenomatous Polyposis, Joint Pain, Low Back Pain, Musculoskeletal Pain, Primary Dysmenorrhea, Rheumatoid Arthritis Pain, Tenosynovitis Celgosivir Celgosivir Dengue, HIV infections, Hepatitis C Alpha-glucosidase inhibitors Ceramide Ceramide trihexosidase/ alpha- galactosidase A ceritinib ceritinib chlorambucil chlorambucil Breast Cancer, Ovarian Cancer, Follicular Lymphoma, Waldenstrom Macroglobulinemia, Lymphoma, Non- Hodgkin Lymphoma, Chronic Lymphocytic Leukemia (CLL), Hodgkin Lymphoma, Indolent Lymphoma, Mantle Cell Lymphoma, Metastatic Ovarian Cancer, Pediatric Cancer cholic acid cholic acid ciclosporin ciclosporin Keratoconjunctivitis sicca (Dry Eye), Corneal Graft Rejection, Vernal Keratoconjunctivitis, Breast Cancer, Lung Cancer, Uveitis, Liver Transplantation, Heart Transplantation, Bone Marrow Transplantation, Lung Transplantation, Psoriasis, Transplantation, Rheumatoid Arthritis, Graft Versus Host Disease (GVHD), Kidney Transplantation, Atopic Dermatitis, Intermediate Uveitis, Posterior Uveitis Cidofovir Cidofovir Cinacalcet Cinacalcet Ciprofloxacin Ciprofloxacin Anthrax, Nosocomial pneumonia, DNA gyrase inhibitors, Respiratory tract infections, Intestinal DNA topoisomerase infections, Acute sinusitis, Typhoid, inhibitors Intra-abdominal infections, Urinary tract infections, Skin and soft tissue infections, Gonorrhoea Cladribine Cladribine Clazosentan Clazosentan Endothelin A receptor antagonists Clevidipine Clevidipine Clofarabine Clofarabine Acute lymphoblastic leukaemia, Apoptosis stimulants, Histiocytosis, Haematological DNA synthesis malignancies, Acute myeloid inhibitors leukaemia, Myelodysplastic syndromes, Chronic lymphocytic leukaemia, Non-Hodgkin's lymphoma, Psoriasis, Solid tumours, B cell lymphoma Clofazimine Clofazimine closantel closantel Colchicine Colchicine Colfosceril Colfosceril palmitate, cetyl alcohol, tyloxapol Conivaptan Conivaptan cortisone cortisone Arthritis, Osteoarthritis, Asthma, Seborrhea, Proteinuria, Juvenile Rheumatoid Arthritis, Retinitis Pigmentosa (Retinitis), Serum Sickness, Polymyositis, Tuberculous Meningitis, Keratitis, Ankylosing Spondylitis (Bekhterev's Disease), Idiopathic Thrombocytopenic Purpura (Immune Thrombocytopenic Purpura), Psoriatic Arthritis, Humoral Hypercalcemia of Malignancy, Psoriasis, Ulcerative Colitis, Rheumatoid Arthritis, Crohn's Disease (Regional Enteritis), Systemic Lupus Erythematosus, Lymphoma, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Allergic Conjunctivitis, Leukemias, Dermatitis, Eczema, Thrombocytopenia, Acquired (Autoimmune) Hemolytic Anemia, Acute and Sub-Acute Bursitis, Acute Nonspecific Tenosynovitis, Acute Rheumatic Heart Disease, Allergic Corneal Marginal Ulcers, Anterior Segment Inflammation, Aspiration Pneumonitis, Atopic Dermatitis, Bacterial Infections, Berylliosis (Chronic Beryllium Disease), Bullous Pemphigoid, Chorioretinitis, Choroiditis, Congenital Adrenal Hyperplasia (Adrenogenital Syndrome), Congenital Hypoplastic Anemia, Contact Dermatitis, Dermatitis Herpetiformis (Duhring's Disease), Diffuse Posterior Uveitis, Drug Hypersensitivity Reactions, Edema, Epicondylitis, Erythema Multiforme, Erythroblastopenia (RBC Anemia), Herpes Zoster Ophthalmicus, Iritis, Juvenile Arthritis, Loeffler Syndrome (Pulmonary Eosinophilia), Mycosis Fungoides, Nonsuppurative Thyroiditis, Optic Neuritis, Pemphigus, Perennial Allergic Rhinitis, Pulmonary Tuberculosis, Seasonal Allergic Rhinitis, Sympathetic Ophthalmia, Symptomatic Sarcoidosis, Trichomonas Vaginitis Crizotinib Crizotinib Cromolyn Cromolyn sodium cyclophosphamide cyclophosphamide Breast Cancer, Lung Cancer, Ovarian Cancer, Burkitt Lymphoma, Testicular Cancer, Throat Cancer, Retinoblastoma, Follicular Lymphoma, Rhabdomyosarcoma, Hematopoietic Stem Cell Transplantation, Vasculitis, Polymyositis, Lupus Erythematosus, Rheumatoid Arthritis, Systemic Lupus Erythematosus, Cervical Cancer, Lymphoma, Melanoma, Multiple Myeloma (Kahler Disease), Non- Hodgkin Lymphoma, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Chronic Lymphocytic Leukemia (CLL), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Hodgkin Lymphoma, Liver Cancer, Pancreatic Cancer, Gastric Cancer, Bladder Cancer, Leukemias, Systemic Sclerosis (Scleroderma), Metastatic Breast Cancer, Small-Cell Lung Cancer, Sarcomas, Solid Tumor, Polycythemia Vera, Endometrial Cancer, Acute Lymphoblastic Lymphoma, Adenocarcinoma, Bone Tumor, Choriocarcinoma (Gestational Trophoblastic Neoplasia), Colon Cancer, Hydatidiform Mole, Kidney Disease, Lymphoblastic Lymphoma, Malignant Neoplasms, Metastatic Melanoma, Mycosis Fungoides, Nephrotic Syndrome, Neuroblastoma, Pediatric Cancer, Pheochromocytoma, Wegener Polyangiitis Cysteamine Cysteamine cytarabine cytarabine Leptomeningeal Disease (Neoplastic Meningitis, Leptomeningeal Carcinomatosis), Non-Hodgkin Lymphoma, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Meningeal Leukemia, Pediatric Cancer, Refractory Leukemia Dabrafenib Dabrafenib dactinomycin dactinomycin Ewing Sarcoma, Testicular Cancer, Uterine Cancer, Rhabdomyosarcoma, Childhood Rhabdomyosarcoma, Melanoma, Solid Tumor, Endometrial Cancer, Choriocarcinoma (Gestational Trophoblastic Neoplasia), Gestational Trophoblastic Disease, Hydatidiform Mole, Kaposi Sarcoma, Locally Recurrent Or Locoregional Solid Malignancies, Metastatic Melanoma, Metastatic Nonseminomatous Testicular Cancer, Metastatic Renal Cell Carcinoma, Pediatric Cancer, Wilms' Tumor (Nephroblastoma) Dalbavancin Dalbavancin Dalfampridine Dalfampridine danazol danazol Endometriosis, Hereditary Follicle Stimulating Angioedema (HAE) (C1 Esterase Hormone Receptor Inhibitor [C1-INH] Deficiency), (Follitropin Receptor Fibrocystic Breast Disease or FSHR) Antagonist; Lutropin Choriogonadotropic Hormone Receptor (Luteinizing Hormone Receptor or LHCGR) Antagonist Dantrolene Dantrolene low- volume Daptomycin Daptomycin Bacteraemia, Bacterial endocarditis, Cell wall inhibitors intravenous Gram-positive infections, Skin and soft tissue infections, Staphylococcal infections, Osteomyelitis, Urinary tract infections, Community-acquired pneumonia, Burns, Gram-Positive Bacterial Infections, Sepsis, Methicillin- Resistant Staphylococcus aureus (MRSA) Infections, Bacteremia, Bacterial Endocarditis, Complicated Skin And Skin Structure Infections (cSSSI), Hospital Acquired Methicillin- Resistant Staphylococcus aureus (HA- MRSA) Infections, Skin And Soft Tissue Infections, Skin Infections, Surgical Wound Infections Darunavir Darunavir HIV-1 infections HIV protease inhibitors dasatinib dasatinib Bile Duct Cancer (Cholangiocarcinoma), Oligodendroglioma, Non-Small Cell Lung Cancer, Myelofibrosis, Gliosarcoma, Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Pancreatic Cancer, Myelodysplastic Syndrome, Systemic Sclerosis (Scleroderma), Metastatic Breast Cancer, Diffuse Large B-Cell Lymphoma, Polycythemia Vera, Hypereosinophilic Syndrome, Interstitial Lung Fibrosis, Metastatic Hormone Refractory (Castration Resistant, Androgen-Independent) Prostate Cancer, Myeloid Metaplasia, Recurrent Glioblastoma Multiforme (GBM), Refractory Multiple Myeloma, Relapsed Multiple Myeloma, Systemic Mastocytosis Daunorubicin Daunorubicin citrate liposome injection Decitabine Decitabine Deferiprone Deferiprone Iron overload, Pantothenate kinase- Chelating agents associated neurodegeneration, Parkinson's disease, HIV infections, Friedreich's ataxia, Kidney disorders Defibrotide Defibrotide delavirdine delavirdine HIV-1 Infection Deoxycholic Deoxycholic Cell membrane acid acid modulators, Membrane lipid modulators deoxythymidine deoxythymidine Desmopressin Desmopressin acetate Dexamethasone Dexamethasone Bacterial Conjunctivitis, Uveitis, Intravitreal Keratitis, Blepharitis, Conjunctivitis, Implant Allergic Conjunctivitis, Anterior Segment Inflammation, Anterior Uveitis, Blepharoconjunctivitis, Corneal Ulcers, Herpes Zoster Ophthalmicus, Iritis, Keratoconjunctivitis, Ocular Inflammation, Scleritis Dexmedetomidine Dexmedetomidine Dexrazoxane Dexrazoxane Dextran sulfate Dextran sulfate Ovarian cancer, Cancer metastases, Platelet-derived HIV infections growth factor inhibitors DHAC DHAC Mesothelioma, Prostate cancer, RNA methylation Cancer inhibitors, RNA synthesis inhibitors Dichlorphenamide Dichlorphenamide Diclofenac Diclofenac Cyclooxygenase transdermal inhibitors second generation Didanosine Didanosine HIV infections, Toxoplasmosis Nucleoside reverse transcriptase inhibitors Didox Didox Cancer, Psoriasis, Cytomegalovirus Ribonucleoside infections, HIV infections triphosphate reductase inhibitors, Ribonucleotide reductase inhibitors Difluprednate Difluprednate Docetaxel Docetaxel Breast Cancer, Lung Cancer, Ovarian Tubulin Inhibitor Cancer, Prostate Cancer, Non-Small Cell Lung Cancer, Esophageal Cancer, Head And Neck Cancer, Gastric Cancer, Metastatic Breast Cancer, Endometrial Cancer, Adenocarcinoma Of The Gastroesophageal Junction, Adenocarcinoma, Head And Neck Cancer Squamous Cell Carcinoma, Hormone Refractory (Castration Resistant, Androgen-Independent) Prostate Cancer, Hormone-Sensitive Prostate Cancer, Metastatic Ovarian Cancer, Metastatic Prostate Cancer, Recurrent Head And Neck Cancer Squamous Cell Carcinoma Dolasetron Dolasetron Nausea and vomiting, Psychotic Serotonin 3 receptor disorders antagonists Doripenem Doripenem Cell wall inhibitors Doxercalciferol Doxercalciferol Calcitriol receptor agonists Doxorubicin Doxorubicin Breast Cancer, Lung Cancer, Ovarian DNA intercalators, liposomal Cancer, Thyroid Cancer, Soft Tissue Type II DNA Sarcoma, Lymphoma, Acute topoisomerase Lymphocytic Leukemia (ALL, Acute inhibitors Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Hodgkin Lymphoma, Gastric Cancer, Bladder Cancer, Metastatic Breast Cancer, Sarcomas, Kaposi Sarcoma, Neuroblastoma, Wilms' Tumor (Nephroblastoma) doxycycline doxycycline Urinary Tract Infections, Malaria, Bacterial Conjunctivitis, Gonorrhea, Rocky Mountain Spotted Fever, Syphilis, Cholera, Upper Respiratory Tract Infections, Lower Respiratory Tract Infections, Acne Vulgaris, Actinomycosis, Anthrax, Bartonellosis, Brucellosis, Chancroid, Extraintestinal Amebiasis, Granuloma Inguinale, Listeriosis, Nongonococcal Urethritis, Plague, Q Fever, Tick-Borne Relapsing Fever, Typhus Fever, Uncomplicated Urethral, Endocervical, or Rectal Infections in Adults, Yaws droxidopa droxidopa Edatrexate Edatrexate Cancer, Rheumatoid arthritis Tetrahydrofolate dehydrogenase inhibitors Efavirenz Efavirenz HIV-1 infections Non-nucleoside reverse transcriptase inhibitors Eflapegrastim Eflapegrastim Granulocyte colony stimulating factor stimulants Eflornithine HCl Eflornithine HCl elvitegravir elvitegravir HIV-1 Infection emtricitabine emtricitabine HIV-1 Infection Enalapril Enalapril maleate maleate (powder for oral solution) Entacapone Entacapone Parkinson's disease, Restless legs Catechol-O- syndrome methyltransferase inhibitors Epacadostat Epacadostat Malignant melanoma, Ovarian cancer, Indoleamine-pyrrole Fallopian tube cancer, Peritoneal 2,3-dioxygenase cancer, Solid tumours, Non-small cell inhibitors lung cancer Epinephrine Epinephrine Asthma, Anaphylaxis, Type I Adrenergic receptor injection Hypersensitivity, Anaphylactic Shock agonists epitiostanol epitiostanol Epoprostenol Epoprostenol intravenous ergotamine ergotamine Migraine 5-Hydroxytryptamine Receptor 1A (5 HT1A or G 21 or Serotonin Receptor 1A or HTR1A) Agonist; 5- Hydroxytryptamine Receptor 1B (5 HT1B or S12 or Serotonin 1D Beta Receptor or Serotonin Receptor 1B or HTR1B) Agonist; 5- Hydroxytryptamine Receptor 1D (5 HT1D or Serotonin 1D Alpha Receptor or Serotonin Receptor 1D or HTR1D) Agonist; Alpha 1 Adrenergic Receptor (ADRA1) Antagonist Eribulin Eribulin Breast Cancer, Prostate Cancer, Non- Small Cell Lung Cancer, Soft Tissue Sarcoma, Lymphoma, Bladder Cancer, Metastatic Breast Cancer, Solid Tumor, Metastatic Hormone Refractory (Castration Resistant, Androgen- Independent) Prostate Cancer, Transitional Cell Cancer (Urothelial Cell Cancer), Ureter Cancer, Urethral Cancer Esomeprazole Esomeprazole Bleeding ulcer; Gastro-oesophageal Proton pump inhibitors reflux; Heartburn; Helicobacter infections; NSAID-induced ulcer; Peptic ulcer; Reflux oesophagitis; Zollinger-Ellison syndrome Esperamicin Esperamicin-A1 Cancer DNA inhibitors Estradiol Estradiol Estrogen receptor transdermal agonists estrogen estrogen Hormonal Contraception Estrogen Receptor (ethinylestradiol + (ESR) Agonist; norethindrone) Progesterone Receptor (Nuclear Receptor Subfamily 3 Group C Member 3 or NR3C3 or PGR) Agonist Ethanolamine Ethanolamine oleate oleate Ethinylestradiol/ Ethinylestradiol/ Estrogen receptor norelgestromin norelgestromin agonists, transdermal Progesterone receptor agonists ethiodized oil ethiodized oil injection etonogestrel etonogestrel Hormonal Contraception Progesterone Receptor (Nuclear Receptor Subfamily 3 Group C Member 3 or NR3C3 or PGR) Agonist everolimus everolimus Exisulind Exisulind Familial adenomatous polyposis, Non- Apoptosis stimulants, small cell lung cancer, Prostate Cyclic GMP cancer, Breast cancer, Small cell lung phosphodiesterase cancer inhibitors, Angiogenesis inhibitors Ezetimibe Ezetimibe Sitosterolaemia, Cholesterol absorption Hypercholesterolaemia, inhibitors Hyperlipoproteinaemia type II, Acute coronary syndromes Ezetimibe/ Ezetimibe/ Hypercholesterolaemia, Acute Cholesterol absorption simvastatin simvastatin coronary syndromes, Hyperlipidaemia, inhibitors, HMG-CoA Aortic valve stenosis reductase inhibitors Faldaprevir Faldaprevir Hepatitis C Hepatitis C virus NS3 protein inhibitors Fasudil Fasudil Cerebral vasospasm, Cerebral Calcium channel ischaemia, Pulmonary arterial antagonists, Protein hypertension, Intracranial thrombosis, kinase C inhibitors, Angina pectoris, Atherosclerosis, HIV- Rho-associated kinase 1 infections inhibitors Felbamate Felbamate Fenoldopam Fenoldopam Fenretinide Fenretinide Breast cancer, Dry age-related Plasma retinol-binding macular degeneration, Glioma, protein inhibitors Prostate cancer, Neuroblastoma, Rheumatoid arthritis, Basal cell cancer, Bladder cancer Ferric Ferric Iron replacements carboxymaltose carboxymaltose Ferumoxytol Ferumoxytol Iron replacements Fialuridine Fialuridine Hepatitis B DNA-directed DNA polymerase inhibitors Finasteride Finasteride Benign prostatic hyperplasia, Alopecia, Cholestenone 5-alpha Prostate cancer reductase inhibitors Fingolimod Fingolimod Multiple sclerosis, Chronic Apoptosis stimulants, inflammatory demyelinating Immunosuppressants, polyradiculoneuropathy, Amyotrophic Sphingosine 1 lateral sclerosis, Renal transplant phosphate receptor rejection, Optic neuritis, Type 1 modulators diabetes mellitus, Rheumatoid arthritis, Graft-versus-host disease, Myocarditis Florbenazine Florbenazine Vesicular monoamine F18 F18 transporter 2 inhibitors Florbetaben F18 Florbetaben F18 Positron-emission tomography enhancers Florbetapir F 18 Florbetapir F 18 Emission-computed tomography enhancers Fludarabine Fludarabine Follicular Lymphoma, B-Cell Chronic DNA synthesis Lymphocytic Leukemia, Refractory inhibitors, Chronic Lymphocytic Leukemia (CLL), Immunosuppressants Chronic Lymphocytic Leukemia (CLL), B-Cell Non-Hodgkin Lymphoma, Mantle Cell Lymphoma Fluorine 18 AV Fluorine 18 AV Positron-emission 1451 1451 tomography enhancers fluorouracil fluorouracil Breast Cancer, Ovarian Cancer, Prostate Cancer, Colorectal Cancer, Cervical Cancer, Liver Cancer, Head And Neck Cancer, Pancreatic Cancer, Gastric Cancer, Actinic (Solar) Keratosis, Endometrial Cancer, Basal Cell Carcinoma (Basal Cell Epithelioma), Paget Disease of Bone, Human Papillomavirus Infections, Kidney Cancer (Renal Cell Cancer), Squamous Cell Carcinoma, Esophageal Cancer, Colorectal Cancer, Cervical Cancer, Liver Cancer, Head And Neck Cancer, Pancreatic Cancer, Gastric Cancer, Adenocarcinoma, Colon Cancer, Gastrointestinal Tract Cancer, Genital Warts (Condylomata Acuminata), Keratoacanthoma, Pediatric Cancer, Rectal Cancer Fluoxymesterone Fluoxymesterone Breast cancer, Delayed puberty, Testosterone agonists Hypogonadism Flutafuranol F Flutafuranol F Positron-emission 18 18 tomography enhancers Flutemetamol F Flutemetamol F Positron-emission 18 18 tomography enhancers Fomepizole Fomepizole Fosaprepitant Fosaprepitant Fosphenytoin Fosphenytoin Sodium channel antagonists Fospropofol Fospropofol Undefined mechanism fulvestrant fulvestrant Breast Cancer, Metastatic Breast Cancer, Hormone Sensitive Breast Cancer Furosemide Furosemide Loop diuretics controlled release Gadobenic acid Gadobenic acid Magnetic resonance imaging enhancers Gadobutrol Gadobutrol Gadoversetamide Gadoversetamide Undefined mechanism Gadoxetate Gadoxetate Magnetic resonance disodium disodium imaging enhancers Ganciclovir Ganciclovir intravitreal implant gemcitabine Gemcitabine Breast Cancer, Lung Cancer, Ovarian DNA synthesis Cancer, Bile Duct Cancer inhibitors (Cholangiocarcinoma), Non-Small Cell Lung Cancer, Epithelial Ovarian Cancer, Cervical Cancer, Non-Hodgkin Lymphoma, Hodgkin Lymphoma, Pancreatic Cancer, Bladder Cancer, Metastatic Breast Cancer, Small-Cell Lung Cancer, Metastatic Pancreatic Cancer, Biliary Tumor, Metastatic Adenocarcinoma of The Pancreas, Metastatic Ovarian Cancer, Non-Small Cell Lung Carcinoma, Renal Cell Carcinoma, Transitional Cell Cancer (Urothelial Cell Cancer), Ureter Cancer, Urethral Cancer Glimepiride Glimepiride Type 2 diabetes mellitus Potassium channel agonists Glycerol Glycerol phenylbutyrate Gonadorelin Gonadorelin acetate acetate Granisetron Granisetron Serotonin 3 receptor transdermal antagonists Guadecitabine Guadecitabine Antimetabolites, DNA cytosine 5 methyltransferase 1 inhibitors Halofantrine Halofantrine Heparin Heparin Disseminated intravascular Thrombin inhibitors coagulation; Peripheral arterial occlusive disorders; Pulmonary embolism; Thromboembolism; Venous thrombosis hydroxychloroquine hydroxychloroquine Malaria, Rheumatoid Arthritis, Systemic Lupus Erythematosus Hydroxyurea Hydroxyurea Ibandronic acid Ibandronic acid Dimethylallyltranstrans- ferase inhibitors ibrutinib ibrutinib ibuprofen ibuprofen Osteoarthritis Pain, Gastric Ulcers, Cyclooxygenase Duodenal Ulcer, Ankylosing inhibitors Spondylitis (Bekhterev's Disease), Musculoskeletal Inflammation, Myalgia, Rheumatoid Arthritis Pain Idarubicin Idarubicin idelalisib idelalisib Idoxuridine Idoxuridine Colorectal cancer, Glioma DNA synthesis inhibitors Ifosfamide Ifosfamide Iloprost Iloprost solution for infusion imatinib imatinib Soft Tissue Sarcoma, Acute mesylate Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Myelodysplastic Syndrome, Gastrointestinal Stromal Tumor (GIST), Myeloproliferative Disorders, Hypereosinophilic Syndrome, Pediatric Cancer, Systemic Mastocytosis Imiquimod Imiquimod Actinic keratosis, Basal cell cancer, Immunostimulants, Genital warts, Herpes simplex virus Toll-like receptor 7 infections, Cervical intraepithelial agonists neoplasia, Warts, Molluscum contagiosum, Tinea pedis, Vulvar intraepithelial neoplasia, Photodamage, Hepatitis C, Hepatitis B, HIV infections Indinavir Indinavir HIV-1 Infection, HIV-2 Infection HIV protease inhibitors Intoplicine Intoplicine Cancer, Solid tumours, Cancer DNA topoisomerase I metastases inhibitors, Type II DNA topoisomerase inhibitors Iobenguane I- Iobenguane I- Enzyme inhibitors, 123 123 Diagnostic imaging enhancers Iobenguane Iobenguane sulfate 131 sulfate I 131 Ioxilan Ioxilan Radiography enhancers Irinotecan Irinotecan Iron Iron Iron replacements isomaltoside isomaltoside 1000 1000 Iron sucrose Iron sucrose Iron replacements Isavuconazonium Isavuconazonium Ivacaftor Lumacaftor/ ivacaftor ivermectin ivermectin Scabies, Elephantiasis (Lymphatic Filariasis), Onchocerciasis (River Blindness), Strongyloidiasis, Rosecea, Head Lice ixabepilone ixabepilone Prostate Cancer, Non-Small Cell Lung Cancer, Esophageal Cancer, Gastric Cancer, Metastatic Breast Cancer, Metastatic Pancreatic Cancer, Solid Tumor, Endometrial Cancer, Adenocarcinoma Ixazomib citrate Ixazomib citrate labelalol labelalol Hypertension Lacosamide Lacosamide Male osteoporosis; Osteoporosis; Postmenopausal osteoporosis lamivudine lamivudine HIV/AIDS, HIV-1 Infection, Hepatitis B Lamotrigine Lamotrigine Bipolar disorders, Lennox-Gastaut Sodium channel syndrome, Partial epilepsies, Tonic- antagonists clonic epilepsy, Absence epilepsy, Epilepsy, Neuropathic pain, Diabetic neuropathies, Schizophrenia Lansoprazole Lansoprazole Lapatinib Lapatinib Breast Cancer, Non-Small Cell Lung Epidermal growth Cancer, Esophageal Cancer, Gastric factor receptor Cancer, Metastatic Pancreatic Cancer, antagonists, ERBB 2 Adenocarcinoma Of The receptor antagonists Gastroesophageal Junction, Head And Neck Cancer Squamous Cell Carcinoma, Metastatic Colorectal Cancer, Non-Neoplastic Neuromas, Vestibular Schwannoma (Acoustic Neuroma) Lazabemide Lazabemide Parkinson's disease, Alzheimer's Monoamine oxidase B disease, Smoking withdrawal inhibitors, Antioxidants L-dopa L-dopa Parkinson's Disease Aromatic L Amino Acid Decarboxylase (AADC or Dopa Decarboxylase or DDC or EC 4.1.1.28) Inhibitor; Catechol O Methyltransferase (Epididymis Secretory Sperm Binding Protein Li 98n or COMT or EC 2.1.1.6) Inhibitor; Dopamine Receptor (DRD) Agonist leflunomide leflunomide Rheumatoid Arthritis Lenalidomide Lenalidomide lenvatinib lenvatinib Letermovir Letermovir Cytomegalovirus replication inhibitors Leucovorin Leucovorin Leuprolide Leuprolide acetate Levetiracetam Levetiracetam SV2A protein modulators Levocarnitine Levocarnitine Levofloxacin Levofloxacin DNA gyrase inhibitors, Type II DNA topoisomerase inhibitors Levoleucovorin Levoleucovorin Levothyroxine Levothyroxine Thyroid Cancer, Goiter, Thyroid hormone sodium Hypothyroidism, Hashimoto Thyroiditis receptor agonists Lidocaine Lidocaine Sodium channel transdermal antagonists patch lidocane lidocane Postherpetic Neuralgia Voltage Gated Sodium Channel (SCN) Blocker Linezolid Linezolid Protein 30S ribosomal subunit inhibitors Lobaplatin Lobaplatin Small cell lung cancer, Chronic Alkylating agents myeloid leukaemia, Breast cancer, Cancer Lodoxamide Lodoxamide tromethamine Lomitapide Lomitapide Hyperlipoproteinaemia type IIa Microsomal triglyceride transfer protein inhibitors lopinavir lopinavir HIV-1 Infection lovastatin lovastatin Myocardial Infarction, Hypercholesterolemia, Atherosclerosis, Unstable Angina, Dyslipidemia, Hyperlipidemia, Coronary Disease, Familial Hypercholesterolemia (Type II Hyperlipoproteinemia) Lumacaftor Lumacaftor/ ivacaftor macitentan macitentan maraviroc maraviroc HIV-1 Infection Mefloquine HCl Mefloquine HCl Meloxicam Meloxicam Cyclo-oxygenase 2 injection inhibitors melphalan melphalan Breast Cancer, Ovarian Cancer, Retinoblastoma, Soft Tissue Sarcoma, Bone Marrow Transplantation, Melanoma, Multiple Myeloma (Kahler Disease), Metastatic Breast Cancer, Polycythemia Vera, Adenocarcinoma, Metastatic Ovarian Cancer, Neuroblastoma mercaptopurine mercaptopurine Acute Lymphocytic Leukemia (ALL, oral solution Acute Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Leukemias, Pediatric Cancer Meropenem Meropenem Febrile neutropenia, Bacterial Cell wall inhibitors infections, Community-acquired pneumonia, Skin and soft tissue infections Mesna Mesna Undefined mechanism methotrexate methotrexate Psoriasis, Rheumatoid Arthritis, Tetrahydrofolate Polyarticular Juvenile Idiopathic dehydrogenase Arthritis (PJIA) inhibitors, Thymidylate synthase inhibitors Methylnaltrexone Methylnaltrexone Opioid mu receptor bromide antagonists Methylphenidate Methylphenidate Adrenergic receptor transdermal modulators, Dopamine release stimulants metoprolol metoprolol Angina (Angina Pectoris), Beta 1 Adrenergic Hypertension, Myocardial Infarction, Receptor (Beta 1 Migraine Adrenoreceptor or ADRB1) Antagonist Mifepristone Mifepristone Miglustat Miglustat Miltefosine Miltefosine Visceral leishmaniasis, Cutaneous Signal transduction leishmaniasis, Cancer metastases, pathway inhibitors Leishmaniasis, Chagas disease, Malignant melanoma Minocycline Minocycline IV Glial cell inhibitors, Protein 30S ribosomal subunit inhibitors mitomycin C mitomycin C Breast Cancer, Lung Cancer, Prostate Cancer, Anal Cancer, Bone Cancer, Non-Small Cell Lung Cancer, Squamous Cell Carcinoma, Uterine Cancer, Malignant Mesothelioma, Colorectal Cancer, Cervical Cancer, Chronic Lymphocytic Leukemia (CLL), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Liver Cancer, Head And Neck Cancer, Pancreatic Cancer, Gastric Cancer, Bladder Cancer, Leukemias, Metastatic Breast Cancer, Sarcomas, Solid Tumor, Adenocarcinoma Of The Gastroesophageal Junction, Colon Cancer, Metastatic Adenocarcinoma of The Pancreas, Non Muscle Invasive Bladder Cancer (NMIBC) (Superficial Bladder Cancer), Skin Cancer Mitoxantrone Mitoxantrone DNA inhibitors, DNA topoisomerase inhibitors, Type II DNA topoisomerase inhibitors, Immunosuppressants Modafinil Modafinil Morphine Morphine Acute Pain, Chronic Pain, Dyspnea Mu Type Opioid Receptor (MOR1 or Mu Opiate Receptor or Mu Opioid Receptor or OPRM1) Agonist Motexafin Motexafin Brain cancer, Non-small cell lung Thioredoxin reductase gadolinium gadolinium cancer, Glioma, Lymphoma, Chronic inhibitors lymphocytic leukaemia, Glioblastoma, Multiple myeloma, Non-Hodgkin's lymphoma, Renal cancer, Cardiovascular disorders, Head and neck cancer, Solid tumours, Amyotrophic lateral sclerosis Moxifloxacin Moxifloxacin Intra-abdominal infections, Acute Type II DNA exacerbations of chronic bronchitis, topoisomerase Community-acquired pneumonia, Skin inhibitors and soft tissue infections, Acute sinusitis, Bacterial infections, Respiratory tract infections, Pelvic inflammatory disorders, Plague, Tuberculosis Mycophenolate Mycophenolate Liver Transplantation, Heart Immunosuppressants, mofetil mofetil Transplantation, Kidney Inosine Transplantation monophosphate dehydrogenase inhibitors Nafarelin Nafarelin acetate Naloxone Naloxone Opioid receptor injection antagonists naproxen naproxen Osteoarthritis Pain, Gastric Ulcers, Ankylosing Spondylitis (Bekhterev's Disease), Rheumatoid Arthritis Pain, Migraine nelarabine nelarabine Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Acute Lymphoblastic Lymphoma nelfinavir nelfinavir HIV-1 Infection Neostigmine Neostigmine Nevirapine Nevirapine HIV-1 infections Non-nucleoside reverse transcriptase inhibitors nilotinib Nilotinib Anaplastic Astrocytoma, Oligodendroglioma, Colorectal Cancer, Pulmonary Arterial Hypertension, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Systemic Sclerosis (Scleroderma), Graft Versus Host Disease (GVHD), Gastrointestinal Stromal Tumor (GIST), Anaplastic Oligoastrocytoma, Head And Neck Cancer Squamous Cell Carcinoma, Metastatic Melanoma, Pigmented Villonodular Synovitis, Recurrent Glioblastoma Multiforme (GBM), Tenosynovitis, Vestibular Schwannoma (Acoustic Neuroma) Nilutamide Nilutamide Prostate cancer Testosterone congener inhibitors nintedanib nintedanib Nitazoxanide Nitazoxanide Nitisinone Nitisinone nitrosoureas nitrosoureas Astrocytoma, Glioblastoma Multiforme (GBM), Metastatic Brain Tumor, Glioma, Ependymoma, Lymphoma, Melanoma, Multiple Myeloma (Kahler Disease), Non-Hodgkin Lymphoma, Hodgkin Lymphoma, Solid Tumor, Brain Tumor, Gastrointestinal Tract Cancer, Medulloblastoma nortriptyline nortriptyline Depression NSC 361456 NSC 361456 Cancer Undefined mechanism obeticholic acid obeticholic acid olaparib olaparib Omacetaxine Omacetaxine Chronic Myelocytic Leukemia (CML, Apoptosis stimulants, mepesuccinate mepesuccinate Chronic Myeloid Leukemia) Cyclin D1 inhibitors, MCL1 protein inhibitors, Protein synthesis inhibitors, Proto oncogene protein c-myc inhibitors Omadacycline Omadacycline Protein synthesis inhibitors Omeprazole Omeprazole Peptic ulcer, Helicobacter infections, Proton pump inhibitors Duodenal ulcer, Gastric ulcer, Gastro- oesophageal reflux, Zollinger-Ellison syndrome, Gastritis, Dyspepsia opioids opioids Pain Oritavancin Oritavancin Orlistat Orlistat Obesity Lipase inhibitors Oxaliplatin Oxaliplatin DNA cross linking agents, DNA synthesis inhibitors oxprenolol oxprenolol Hypertension Oxybate Oxybate Oxybutynin Oxybutynin Cholinergic receptor antagonists, Muscarinic receptor antagonists Oxymetholone Oxymetholone Anaemia, Cachexia Protein synthesis stimulants, Stem cell stimulants, Testosterone congener stimulants Paclitaxel Paclitaxel Ovarian cancer, Breast cancer, Gastric Mitosis inhibitors, cancer, Kaposi's sarcoma, Non-small Proto-oncogene cell lung cancer, Cervical cancer, protein c-bcl-2 Multiple myeloma, Head and neck inhibitors, Tubulin cancer, Prostate cancer, Cancer polymerisation metastases, Bladder cancer, Testicular promoters cancer, Endometrial cancer, Non- Hodgkin's lymphoma, Sarcoma, Lung cancer, Mesothelioma, Leukaemia, Pleural effusion, Small cell lung cancer Hemin Hemin Pantoprazole Pantoprazole Paracetamol Paracetamol Fever; Pain intravenous Paricalcitol Paricalcitol Calcitriol receptor agonists, Parathyroid hormone receptor antagonists Pazopanib Pazopanib Pemetrexed Pemetrexed Non-small cell lung cancer, Antimetabolites, Mesothelioma, Breast cancer, Non- Tetrahydrofolate Hodgkin's lymphoma, Head and neck dehydrogenase cancer, Ovarian cancer, inhibitors, Thymidylate Osteosarcoma, Renal cancer, Small synthase inhibitors cell lung cancer Pentamidine Pentamidine isethionate isethionate pentazocine pentazocine Pain, Moderate Pain (acetaminophen + pentazocine hydrochloride) Pentosan Pentosan polysulfate sodium Pentostatin Pentostatin Hairy cell leukaemia, Cutaneous T cell Adenosine deaminase lymphoma, Graft-versus-host disease, inhibitors, Non-Hodgkin's lymphoma, Rheumatoid Immunomodulators arthritis Peramivir Peramivir Perflexane Perflexane Perflutren Perflutren Undefined mechanism Phenylephrine Phenylephrine intravenous Piperacillin/ Piperacillin/ Beta lactamase tazobactam tazobactam inhibitors, Cell wall inhibitors Pirmenol Pirmenol Ventricular arrhythmias Calcium channel antagonists, Muscarinic M2 receptor antagonists, Potassium channel antagonists, Sodium channel antagonists Plazomicin Plazomicin Protein synthesis inhibitors Plerixafor Plerixafor CXCR4 receptor antagonists Polidocanol Polidocanol Pomalidomide Pomalidomide ponatinib ponatinib Glioblastoma Multiforme (GBM), Non- hydrochloride Small Cell Lung Cancer, Acute Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia), Acute Myelocytic Leukemia (AML, Acute Myeloblastic Leukemia), Chronic Myelocytic Leukemia (CML, Chronic Myeloid Leukemia), Gastrointestinal Stromal Tumor (GIST), Biliary Tumor, Medullary Thyroid Cancer Posaconazole Posaconazole pralatrexate Pralatrexate Non-Small Cell Lung Cancer, Antimetabolites, Esophageal Cancer, Cutaneous T-Cell Tetrahydrofolate Lymphoma, Hodgkin Lymphoma, dehydrogenase Gastric Cancer, Bladder Cancer, Oral inhibitors Mucositis, Metastatic Breast Cancer, B-Cell Non-Hodgkin Lymphoma, Peripheral T-Cell Lymphomas (PTCL), Transitional Cell Cancer (Urothelial Cell Cancer) prednisolone prednisolone Burns, Keratitis, Blepharitis, Conjunctivitis, Anterior Uveitis, Herpetic Keratitis, Ocular Inflammation, Scleritis prednisone predisone Multiple Sclerosis, Asthma, Sicca Syndrome (Sjogren), Proteinuria, Uveitis, Juvenile Rheumatoid Arthritis, Vasculitis, Chronic Obstructive Pulmonary Disease (COPD), Idiopathic Pulmonary Fibrosis, Hypoxemia, Serum Sickness, Polymyositis, Tuberculous Meningitis, Gouty Arthritis (Gout), Ankylosing Spondylitis (Bekhterev's Disease), Idiopathic Thrombocytopenic Purpura (Immune Thrombocytopenic Purpura), Psoriatic Arthritis, Polymyalgia Rheumatica, Dermatomyositis, Ulcerative Colitis, Transplantation, Rheumatoid Arthritis, Crohn's Disease (Regional Enteritis), Systemic Lupus Erythematosus, Dermatitis, Thrombocytopenia, Acquired (Autoimmune) Hemolytic Anemia, Adrenal Insufficiency, Allergic Bronchopulmonary Aspergillosis, Aspiration Pneumonitis, Atopic Dermatitis, Bronchiolitis Obliterans, Congenital Adrenal Hyperplasia (Adrenogenital Syndrome), Contact Dermatitis, Dermatitis Herpetiformis (Duhring's Disease), Drug Hypersensitivity Reactions, Edema, Erythema Multiforme, Idiopathic Eosinophilic Pneumonia, Idiopathic Interstitial Pneumonia (IIP), Nonsuppurative Thyroiditis, Ocular Inflammation, Pemphigus, Perennial Allergic Rhinitis, Pneumocystis carinii Pneumonia, Pulmonary Tuberculosis, Respiratory Hypersensitivity, Seasonal Allergic Rhinitis, Sympathetic Ophthalmia, Symptomatic Sarcoidosis Propofol Propofol GABA receptor agonists propranolol propranolol Angina (Angina Pectoris), Beta 1 Adrenergic Hypertension, Myocardial Infarction, Receptor (Beta 1 Migraine, Atrial Fibrillation, Essential Adrenoreceptor or Tremor, Pheochromocytoma, ADRB1) Antagonist; Tachycardia (Tachyarrhythmias), Beta 2 Adrenergic Hyperthyroidism, Ventricular Receptor (Beta 2 Arrhythmia, Wolff-Parkinson-White Adrenoreceptor or Syndrome ADRB2) Antagonist Quinapril Quinapril ACE inhibitors Quinine sulfate Quinine sulfate Quinupristin/ Quinupristin/ Enterococcal infections, Gram-positive Protein synthesis dalfopristin dalfopristin infections, Skin and soft tissue inhibitors infections, Nosocomial pneumonia Raloxifene Raloxifene Postmenopausal osteoporosis, Breast Selective estrogen cancer, Fracture, Cardiovascular receptor modulators disorders, Endometriosis, Vasomotor symptoms, Hypercholesterolaemia, Leiomyoma raltegravir raltegravir HIV/AIDS, HIV-1 Infection Raltitrexed Raltitrexed Colorectal cancer, Mesothelioma Thymidylate synthase inhibitors Ramatroban Ramatroban Allergic rhinitis, Asthma, Ischaemic Thromboxane A2 heart disorders, Thrombosis receptor antagonists Regadenoson Regadenoson Coronary disorders Adenosine A2 receptor agonists Regorafenib Regorafenib Remacemide Remacemide Huntington's disease, Epilepsy, Stroke, Glutamate receptor Neurological disorders, Parkinson's antagonists, NMDA disease, Neuropathic pain receptor antagonists riboflavin riboflavin ophthalmic solution & ultraviolet A Rifabutin Rifabutin Rifampin Rifampin Rifapentine Rifapentine Tuberculosis, Mycobacterium avium Protein 50S ribosomal complex infections subunit inhibitors Rifaximin Rifaximin rilpivirine rilpivirine HIV-1 Infection Riluzole Riluzole Riociguat Riociguat Ritonavir Ritonavir Hepatitis C, HIV-1 Infection HIV protease inhibitors RO 316840 RO 316840 Hepatitis B, HIV infections RNA-directed DNA polymerase inhibitors Romidepsin Romidepsin Ropeginterferon Ropeginterferon Interferon alpha 2b alfa-2b alfa-2b stimulants rosuvastatin rosuvastatin Rotigotine Rotigotine Dopamine D2 receptor agonists Rufinamide Rufinamide Ruxolitinib Ruxolitinib Phosphate Sabril Sabril salbutamol salbutamol Asthma, Bronchospasm, Obstructive Pulmonary Disease, Chronic Obstructive Pulmonary Disease (COPD), Chronic Bronchitis, Emphysema, Exercise-Induced Bronchoconstriction (EBI), Premature Labor (Tocolysis), Pulmonary Tuberculosis, Status Asthmaticus Salmeterol Salmeterol Arachidonic acid injection inhibitors, Beta 2 adrenergic receptor agonists Samarium 153 Samarium 153 Ionising radiation lexidronam lexidronam emitters, Reactive oxygen species stimulants Sapropterin Sapropterin saquinavir saquinavir HIV-1 Infection HIV 1 Retropepsin (HIV Aspartyl Protease or HIV Proteinase or Retroproteinase or Gag Protease or HIV Aspartyl Protease or EC 3.4.23.16) Inhibitor; HIV 2 Retropepsin (HIV 2 Protease or EC 3.4.23.47) Inhibitor Satraplatin Satraplatin Squamous cell cancer, Prostate DNA cross linking cancer, Non-small cell lung cancer, agents, DNA synthesis Breast cancer, Solid tumours inhibitors Sedoxantrone Sedoxantrone Prostate cancer, Colorectal cancer, DNA helicase Solid tumours inhibitors, DNA inhibitors Selexipag Selexipag Semaxanib Semaxanib Kaposi's sarcoma, Colorectal cancer, Angiogenesis Non-small cell lung cancer, Acute inhibitors, Protein myeloid leukaemia, Solid tumours, tyrosine kinase Cancer metastases inhibitors, Vascular endothelial growth factor receptor-2 antagonists Sertraline Sertraline Major depressive disorder, Panic Serotonin uptake disorder, Post-traumatic stress inhibitors disorders, Social phobia, Obsessive- compulsive disorders, Premenstrual dysphoric disorder, Generalised anxiety disorder, Premature ejaculation, Obesity Sildenafil Sildenafil Simvastatin Simvastatin Hypertriglyceridaemia, HMG-CoA reductase Hypercholesterolaemia, Low HDL inhibitors, Nitric oxide cholesterol, Hyperlipoproteinaemias, synthase type II Diabetic cardiomyopathy, Cystic inhibitors fibrosis, Multiple sclerosis, Alzheimer's disease, Bone resorption, Rheumatoid arthritis sirolimus sirolimus Arteriovenous Fistula, Benign Cardiovascular Tumor, Dermatological Disorders, Kidney Transplantation, Choroidal Neovascularization, Diabetic Macular Edema, Keratoconjunctivitis sicca (Dry Eye), Dry (Atrophic) Macular Degeneration, Posterior Uveitis, Wet (Neovascular/Exudative) Macular Degeneration Sodium ferric Sodium ferric Iron replacements gluconate gluconate complex Sodium nitrite- Sodium nitrite- sodium sodium thiosulfate thiosulfate combination combination therapy therapy Sodium Sodium Ammonia scavengers phenylacetate/ phenylacetate/ sodium sodium benzoate benzoate Sodium Sodium phenylbutyrate phenylbutyrate Sorafenib Sorafenib Sorivudine Sorivudine Herpes zoster RNA-directed DNA polymerase inhibitors Sotalol IV Sotalol Stavudine Stavudine HIV-1 infections Nucleoside reverse transcriptase inhibitors sulfasalazine sulfasalazine Colitis, Ulcerative Colitis, Crohn's Disease (Regional Enteritis), Proctitis Sumatriptan Sumatriptan Serotonin 1D receptor transdermal agonists Sunitinib Sunitinib Pancreatic cancer, Gastrointestinal Colony stimulating stromal tumours, Renal cancer, factor receptor Prostate cancer, Oesophageal cancer, antagonists, Fms-like Thyroid cancer, Bladder cancer, tyrosine kinase 3 Malignant melanoma, Soft tissue inhibitors, Platelet sarcoma, Hepatocellular carcinoma, derived growth factor Germ cell and embryonal neoplasms, alpha receptor Non-small cell lung cancer, Breast antagonists, Platelet- cancer, Colorectal cancer, Gastric derived growth factor cancer, Urogenital cancer, Acute beta receptor myeloid leukaemia antagonists, Proto oncogene protein c ret inhibitors, Proto oncogene protein c-kit inhibitors, Vascular endothelial growth factor receptor 3 antagonists, Vascular endothelial growth factor receptor-1 antagonists, Vascular endothelial growth factor receptor-2 antagonists Tacrine Tacrine Alzheimer's disease, HIV infections Acetylcholinesterase inhibitors Tacrolimus Tacrolimus Transplant rejection, Atopic dermatitis, Calcineurin inhibitors, Ulcerative colitis, Myasthenia gravis, Cytokine inhibitors, Intestinal transplant rejection, Graft- Immunosuppressants, versus-host disease, Interstitial lung T cell activation diseases, Lupus nephritis, Allergic inhibitors conjunctivitis, Rheumatoid arthritis, Coronary artery restenosis, Open- angle glaucoma, Psoriasis, Eye disorders, Dry eyes, Lupus Nephritis, Myasthenia Gravis, Pneumonia, Liver Transplantation, Heart Transplantation, Bone Marrow Transplantation, Lung Transplantation, Ulcerative Colitis, Rheumatoid Arthritis, Crohn's Disease (Regional Enteritis), Eczema, Kidney Transplantation, Atopic Dermatitis Tanomastat Tanomastat Non-small cell lung cancer, Ovarian Angiogenesis cancer, Pancreatic cancer, Small cell inhibitors, Matrix lung cancer, Osteoarthritis metalloproteinase inhibitors tasimelteon tasimelteon Tc 99m apcitide Tc 99m apcitide Radionuclide imaging enhancers Tc 99m Tc 99m Single-photon ethylenedicysteine ethylenedicysteine emission-computed deoxyglucose deoxyglucose tomography enhancers Tedizolid Tedizolid Teicoplanin Teicoplanin Gram-positive infections, Bacterial Cell wall inhibitors infections Telavancin Telavancin Cell membrane permeability enhancers, Cell wall inhibitors Telithromycin Telithromycin Acute sinusitis, Gram-positive Protein 50S ribosomal infections, Community-acquired subunit inhibitors pneumonia, Tonsillitis, Acute exacerbations of chronic bronchitis, Pharyngitis, Respiratory tract infections, Obstetric and gynaecological infections, Pelvic inflammatory disorders, Skin and soft tissue infections, Toxoplasmosis Temafloxacin Temafloxacin Bacterial infections Type II DNA topoisomerase inhibitors Temozolomide Temozolomide Temsirolimus Temsirolimus Mantle-cell lymphoma, Renal cancer, MTOR protein Glioblastoma, Hodgkin's disease, inhibitors Glioma, Non-Hodgkin's lymphoma, Head and neck cancer, Follicular lymphoma, Lymphoma, Acute lymphoblastic leukaemia, Colorectal cancer, Solid tumours, Prostate cancer, Multiple myeloma, Breast cancer, Soft tissue sarcoma, Pancreatic cancer Teniposide Teniposide tenofovir tenofovir HIV-1 Infection Terbinafine Terbinafine Mycoses, Tinea cruris, Pityriasis Squalene versicolor, Tinea pedis, Tinea corporis, monooxygenase Tinea capitis inhibitors Testosterone Testosterone Breast cancer, Delayed puberty, Androgen Receptor propionate propionate Hypogonadism, Menopausal (Dihydrotestosterone syndrome, Decreased libido, Male Receptor or Nuclear Hypogonadism, Secondary Receptor Subfamily 3 (Hypogonadotropic) Hypogonadism, Group C Member 4 or Testicular (Primary) Hypogonadism, DHTR or NR3C4 or Testicular Diseases AR) Agonist Thalidomide Thalidomide Tianeptine Tianeptine Anxiety disorders, Major depressive Serotonin uptake disorder, Alcoholism, Irritable bowel stimulants syndrome, Asthma Tigecycline Tigecycline Tinzaparin Tinzaparin Factor Xa inhibitors, sodium sodium Thrombin inhibitors Tiopronin Tiopronin Tizanidine Tizanidine Muscle spasticity, Migraine, Alpha 2 adrenergic Fibromyalgia receptor agonists Tobramycin Tobramycin for inhalation Tolcapone Tolcapone Parkinson's disease Catechol-O- methyltransferase inhibitors Tolrestat Tolrestat Diabetic complications Aldehyde reductase inhibitors Tolvaptan Tolvaptan Oedema, Hyponatraemia, Cardiac Vasopressin V2 oedema, Autosomal dominant receptor antagonists polycystic kidney disease, Renal failure, Ascites Topiramate Topiramate Epilepsy, Migraine, Lennox-Gastaut AMPA receptor syndrome, Obesity, Post-traumatic antagonists, Carbonic stress disorders, Diabetic anhydrase inhibitors, neuropathies, Bipolar disorders GABA-A receptor antagonists, Kainic acid receptor antagonists, Sodium channel antagonists, GABA A receptor agonists Topotecan Topotecan Small cell lung cancer, Ovarian cancer, DNA topoisomerase I Cervical cancer, Brain cancer inhibitors Trabectedin Trabectedin Trametinib Trametinib Treprostinil Treprostinil Pulmonary Arterial Hypertension Prostacyclin Receptor (Prostaglandin I2 Receptor or Prostanoid IP Receptor or PTGIR) Agonist Tretinoin Tretinoin Triciribine Triciribine Ovarian cancer, Breast cancer, Acute DNA synthesis myeloid leukaemia, Solid tumours, inhibitors, Protein Haematological malignancies, kinase inhibitors, Proto Pancreatic cancer, HIV infections, oncogene protein c- Cancer akt inhibitors Trientine Trientine HCl Trimetrexate Trimetrexate Pneumocystis pneumonia, Colorectal Tetrahydrofolate cancer, Bladder cancer, Lung cancer, dehydrogenase Cancer, Pancreatic cancer, Cervical inhibitors cancer, Non-small cell lung cancer, Breast cancer, Gastric cancer, Psoriasis, Leukaemia, Rheumatoid arthritis Trovafloxacin Trovafloxacin Bacterial infections, Genital tract Type II DNA infections, Respiratory tract infections, topoisomerase Toxoplasmosis inhibitors Uridine Uridine triacetate triacetate Ursodiol Ursodiol Vandetanib Vandetanib venetoclax venetoclax verapamil verapamil Angina (Angina Pectoris), Hypertension, Unstable Angina, Renal (Renovascular) Hypertension, Atrial Fibrillation, Ischemia, Atrial Flutter, Chronic Stable Angina, Idiopathic (Essential) Hypertension, Paroxysmal Ventricular Tachycardia, Supraventricular Tachycardia, Vasospastic Angina, Wolff-Parkinson- White Syndrome Verteporfin Verteporfin vinblastine vinblastine Breast Cancer, Testicular Cancer, Lymphoma, Hodgkin Lymphoma, Carcinomas, Gestational Trophoblastic Disease, Kaposi Sarcoma, Letterer- Siwe Disease (Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis), Mycosis Fungoides vincristine vincristine Metastatic Uveal Melanoma, Non- Tubulin polymerisation sulfate sulfate Hodgkin Lymphoma, Acute inhibitors Lymphocytic Leukemia (ALL, Acute Lymphoblastic Leukemia) Vinorelbine Vinorelbine Non-small cell lung cancer, Breast Mitosis inhibitors, cancer, Ovarian cancer, Head and Tubulin polymerisation neck cancer, Prostate cancer, Small inhibitors cell lung cancer, Cervical cancer, Malignant melanoma, Multiple myeloma Vismodegib Vismodegib Basal cell cancer, Pancreatic cancer, Hedgehog cell- Basal cell nevus syndrome, Gastric signalling pathway cancer, Small cell lung cancer, inhibitors Medulloblastoma, Breast cancer, Chondrosarcoma, Myelofibrosis, Idiopathic pulmonary fibrosis, Glioblastoma, Colorectal cancer, Chronic lymphocytic leukaemia, Ovarian cancer, B cell lymphoma, Myelodysplastic syndromes, Acute myeloid leukaemia, Prostate cancer, Sarcoma Vitamin B12 Vitamin B12 fluorescent- fluorescent- analogues analogues Voglibose Voglibose Type 2 diabetes mellitus Alpha-glucosidase inhibitors, Glucagon- like peptide 1 stimulants Voriconazole Voriconazole Zafirlukast Zafirlukast Asthma Leukotriene D4 receptor antagonists, Leukotriene E4 receptor antagonists zalcitabine zalcitabine HIV/AIDS zidovudine zidovudine HIV-1 Infection, HIV-2 Infection Zileuton Zileuton Asthma, Ulcerative colitis, Chronic 5-lipoxygenase obstructive pulmonary disease, Acute inhibitors asthma, Acne, Atopic dermatitis, Rheumatoid arthritis, Cancer, Allergic rhinitis, Atherosclerosis, Nasal polyps Zoledronic acid Zoledronic acid Osteitis deformans, Bone metastases, Bone resorption factor Malignant hypercalcaemia, inhibitors, Postmenopausal osteoporosis, Geranyltranstransferase Corticosteroid-induced osteoporosis, inhibitors, Multiple myeloma, Male osteoporosis, Osteoclast inhibitors Fracture, Mesothelioma, Osteoporosis, Breast cancer, Osteogenesis imperfecta, Osteosarcoma, Rheumatoid arthritis

In some embodiments, the therapeutic agent is an antimicrobial, antiviral, antiparasitic, anticancer agent, or other therapeutic agent selected from those in Table 2, below; or a pharmaceutically acceptable salt thereof.

TABLE 2 Exemplary Therapeutic Agents and Associated Diseases and Disorders Therapeutic Agent Name Indication Mechanism of Action Therapeutic Area Amikacin liposomal Cystic fibrosis-associated respiratory tract infections, Protein 30S ribosomal Bacterial Infections, Drug inhaled - Insmed Mycobacterial infections, Bronchiectasis subunit inhibitors Delivery Systems Azithromycin Community-acquired pneumonia, Bacterial infections, Acute Protein 50S ribosomal Bacterial Infections, Digestive sinusitis, Pelvic inflammatory disorders, Otitis media, subunit inhibitors System Disorders, Ischaemic Sexually transmitted infections, Cystic fibrosis-associated Heart Disease, Obstructive respiratory tract infections, Cholera, Asthma, Pertussis, Airways Disease Typhoid, Gastroparesis, Acute coronary syndromes Cefepime Intra-abdominal infections, Bacterial infections, Skin Cell wall inhibitors Bacterial Infections and soft tissue infections, Urinary tract infections, Respiratory tract infections, Febrile neutropenia Ceftaroline Community-acquired pneumonia, Skin and soft tissue Cell wall inhibitors, Bacterial Infections fosamil infections, Methicillin-resistant Staphylococcus aureus Penicillin-binding infections, Bacteraemia, Sepsis, Bacterial infections, protein inhibitors Osteomyelitis Ceftazidime - B CNS infections, Skin and soft tissue infections, Cell wall inhibitors Bacterial Infections Braun Medical Bacteraemia, Intra-abdominal infections, Gynaecological infections, Bone and joint infections, Respiratory tract infections Ceftolozane/ Intra-abdominal infections, Gram-negative infections, Beta lactamase inhibitors, Bacterial Infections tazobactam Urinary tract infections, Pyelonephritis, Nosocomial Cell wall inhibitors pneumonia Ceftriaxone Pelvic inflammatory disorders, Respiratory tract Cell wall inhibitors Bacterial Infections injectable infections, Skin and soft tissue infections, Otitis media, Gonorrhoea, Bone and joint infections, Epididymitis, Urinary tract infections, Meningococcal infections Cidofovir Cytomegalovirus retinitis, Cystitis, Polyomavirus DNA-directed DNA Cancer, Genitourinary infections, Herpes simplex virus infections, Human polymerase inhibitors, Disorders, Rheumatic papillomavirus infections, Kaposi's sarcoma, Viral Immunomodulators Disease, Viral Infections infections, Molluscum contagiosum, Cancer, Rheumatic disorders Delafloxacin Skin and soft tissue infections, Community-acquired DNA gyrase inhibitors, Bacterial Infections pneumonia, Nosocomial pneumonia, Urinary tract DNA topoisomerase infections, Intra-abdominal infections, Gonorrhoea, IV inhibitors Acute exacerbations of chronic bronchitis, Anthrax Doripenem Gram-positive infections, Gram-negative infections, Cell wall inhibitors Bacterial Infections Paediatric infections, Intra-abdominal infections, Urinary tract infections, Meningococcal infections, Nosocomial pneumonia, Respiratory tract infections, Pneumonia, Bacterial infections Eravacycline Urinary tract infections, Intra-abdominal infections, Protein 30S ribosomal Bacterial Infections Respiratory tract infections subunit inhibitors Fosfomycin Urinary tract infections, Intra-abdominal infections, Cell wall inhibitors, Bacterial Infections intravenous - Skin and soft tissue infections, Pseudomonal infections Peptidoglycan inhibitors Zavante Therapeutics Gentamicin Postoperative infections, Diabetic foot ulcer Protein 30S ribosomal Bacterial Infections, implant - subunit inhibitors Drug Delivery Systems, Innocoll Skin Disorders Iclaprim Skin and soft tissue infections, Nosocomial infections, Tetrahydrofolate Bacterial Infections, Nosocomial pneumonia, Gonorrhoea, Chlamydial infections dehydrogenase inhibitors Mycoses Isavuconazonium Aspergillosis, Zygomycosis, Candidiasis, Mycoses 14-alpha demethylase Mycoses inhibitors Lefamulin Community-acquired pneumonia, Skin and soft tissue Peptidyltransferase Bacterial Infections infections, Bone and joint infections, modulators, Protein Osteomyelitis, Sexually transmitted infections, 50S ribosomal subunit Nosocomial pneumonia modulators Letermovir Cytomegalovirus infections Cytomegalovirus Viral Infections replication inhibitors Levofloxacin Respiratory tract infections, Skin and soft tissue DNA gyrase Bacterial Infections, infections, Prostatitis, Bacterial infections, Urinary inhibitors, Type Viral Infections tract infections, Acute sinusitis, Acute exacerbations II DNA topoisomerase of chronic bronchitis, Community-acquired pneumonia, inhibitors Anthrax, Nosocomial pneumonia, Sinusitis, Pneumonia, Pyelonephritis, Postoperative infections, Tuberculosis, Gynaecological infections Linezolid Vancomycin-resistant enterococcal infections, Nosocomial Protein 30S ribosomal Bacterial Infections pneumonia, Nosocomial infections, Diabetic foot ulcer, subunit inhibitors Gram-positive infections, Methicillin-resistant Staphylococcus aureus infections, Community-acquired pneumonia, Skin and soft tissue infections, Bacterial infections Meropenem Febrile neutropenia, Bacterial infections, Community- Cell wall inhibitors Bacterial Infections acquired pneumonia, Skin and soft tissue infections Meropenem - B Skin and soft tissue infections, Intra-abdominal Cell wall inhibitors Bacterial Infections Braun Medical infections, Bacterial meningitis Meropenem/ Pyelonephritis, Bacteraemia, Gram-negative infections, Beta lactamase Bacterial Infections, vaborbactam Urinary tract infections, Pneumonia inhibitors, Cell Genitourinary Disorders wall inhibitors Minocycline IV - Gram-positive infections, Gram-negative infections Glial cell inhibitors, Bacterial Infections Rempex Protein 30S ribosomal Pharmaceuticals subunit inhibitors Moxifloxacin Intra-abdominal infections, Acute exacerbations of Type II DNA Bacterial Infections chronic bronchitis, Community-acquired pneumonia, topoisomerase Skin and soft tissue infections, Acute sinusitis, inhibitors Bacterial infections, Respiratory tract infections, Pelvic inflammatory disorders, Plague, Tuberculosis Moxifloxacin Community-acquired pneumonia, Intra-abdominal Type II DNA Bacterial Infections injection infections, Acute exacerbations of chronic bronchitis, topoisomerase Skin and soft tissue infections, Acute sinusitis inhibitors Omadacycline Skin and soft tissue infections, Community-acquired Protein synthesis Bacterial Infections pneumonia, Urinary tract infections, Nosocomial inhibitors infections, Acute sinusitis, Anthrax, Plague Oseltamivir Influenza virus infections Neuraminidase inhibitors Viral Infections Peramivir Influenza A virus H1N1 subtype, Influenza virus Neuraminidase inhibitors Viral Infections infections Plazomicin Urinary tract infections, Bacteraemia, Pyelonephritis, Protein synthesis Bacterial Infections Nosocomial pneumonia, Gram-negative infections, inhibitors Respiratory tract infections, Yersinia infections, Tularaemia Ropeginterferon Polycythaemia vera, Essential thrombocythaemia, Interferon alpha 2b Cancer, Haematological alfa-2b Hepatitis B, Hepatitis C, Myelofibrosis, Chronic stimulants Disorders, Viral myeloid leukaemia, Cancer Infections Rose bengal Malignant melanoma, Psoriasis, Atopic dermatitis, Cell death stimulants, Cancer, Skin Disorders sodium Liver metastases, Hepatocellular carcinoma, Breast Cell membrane modulators, cancer, Neuroendocrine tumours, Acne vulgaris Immunostimulants Solithromycin Community-acquired pneumonia, Chlamydial infections, Protein 50S ribosomal Bacterial Infections, Gonorrhoea, Urethritis, Chronic obstructive pulmonary subunit inhibitors Liver Disorders, disease, Non-alcoholic steatohepatitis, Parasitic Infections, Otorhinolaryngological infections, Tularaemia, Respiratory Tract Bacterial infections, Anthrax, Obstetric and Disorders gynaecological infections, Otitis media, Cystic fibrosis, Mycoplasma infections, Legionella infections, Enterococcal infections, Mycobacterium avium complex infections, Malaria Tedizolid Skin and soft tissue infections, Nosocomial pneumonia, Ribosomal protein Bacterial Infections Bacteraemia, Gram-positive infections inhibitors

In some embodiments, the therapeutic agent is selected from Gentamicin, Tobramycin, Amikacin, Kanamycin, Neomycin, Netilmicin, Paromomycin, Spectinomycin, Ampicillin, Ampicillin-sulbactam, Azithromycin, Aztreonam, Benzathine Penicillin, Cefotaxime, Ceftaroline, Fosamil, Ceftriaxone, Ciprofloxacin, Clindamycin, Doxycycline, Ertapenem, Imipenem-cistlastin, Levofloxacin, Merropenem, Metronidazole, Moxifloxacin, Rifampin, Tigecycline, Vancomycin, Oritavancin, Tedizolid, Telavancin Nafcillin, or Oxacillin; or a pharmaceutically acceptable salt thereof.

In some embodiments, the therapeutic agent is one of those in Table 3, below; or a pharmaceutically acceptable salt thereof.

TABLE 3 Exemplary Therapeutic Agents and Associated Diseases and Disorders Active Target-based Drug Name Indications Actions Structure immunosuppressant, Panax IC-101 Cell adhesion molecule inhibitor P-21 WF-10917 reblastatin CKD-461 sulfircin analogs, GPC Hydrolase inhibitor; Protein phosphatase inhibitor

AZD-2315 curdlan sulfate SCH-204698 CD80 antagonist; T cell surface glycoprotein CD28 inhibitor TAK-603 terprenin derivatives, Shionogi

microcolins, RCT

IMPDH inhibitors Inosine (transplant monophosphate rejection/rheumatoid dehydrogenase athritis), c-a-i-r inhibitor biosciences PMI-001 Cyclooxygenase 2 inhibitor; IL-2 antagonist; Inducible nitric oxide synthase inhibitor; Interleukin-1 beta ligand inhibitor; TNF alpha ligand inhibitor APS-2010 alkaloidal immunosuppresants, C-TRI kanglemycin C (immune diasease), Henan Topfond Pharmaceutical kirenol (rheumatoid Rheumatoid arthritis), Peking arthritis University Health Science Center glucocorticoid/rIL-2 Immune disorder; Glucocorticoid (inflammation/immune- Inflammatory agonist; IL-2 mediated disease; agonise; disorders/transplant Transplant Interleukin-2 ligand rejection), NCI rejection T-cell targeted anti- Lck tyrosine Lck SH2 agents kinase inhibitor (rheumatoid arthritis), Mogam tacrolimus Atopic dermatitis Calcineurin (transdermal inhibitor nanoscale lipid emulsion ointment/Nanoaqualip, atopic dermatitis), Jina Pharmaceutical/Intas Pharmaceuticals tacrolimus Organ Calcineurin (intravenous transplantation inhibitor nanosomal lipid suspension/Nanoaqua- lip, organ transplantation), Jina Pharmaceuticals/Intas Pharmaceuticals GPCR modulators Autoimmune Unspecified GPCR (neurodegenerative disease; modulator disease/autoimmune Metabolie disease/metabolic disorder; disease), Neurodegenerative GinkgoPharma diasease thiopalmitoylated peptides (autoimmune disease), University of Queensland mometasone furoate Atopic dermatitis; (topical foam, Dermatological psoriasis/atopic disease; dermatitis), Foamix Psoriasis vioprolides (inflammatory/auto- immune disease), HZI

triptolide Autoimmune disease MDX-3 Systemic lupus erythematosus low molecular Islet cell weight dextran transplant sulfate (intravenous, rejection islet cell transplant rejection), TikoMed tacrolimus Organ Calcineurin (oral/nanosomal/lipid transplantation inhibitor suspension/Nanoaqua- lip, transplantation), Jina Pharmaceuticals/Intas Pharmaceuticals higher fatty acids (cancer/transplantation on rejection), Xiamen University/Guangxi Normal University Cancer; Transplant rejection

REC-200 Glucocorticoid antagonist ciclosporin + Calcineurin prednisolone inhibitor; (allergic Glucocorticoid conjunctivitis), agonist CombinaoRx/Fovea oxfenmino Cannabinoid hydrochloric acid receptor antagonist; Sphingosine-1- phosphate receptor-1 agonist RDP-58 IL12 gene inhibitor; Interferon gamma receptor antagonist; p38 MAP kinase inhibitor PBI-1308 Immunoglobulin G (dermatological, modulator dermatological diseases), Darier/ProMetic EndoS Autoimmune Unspecified disease; enzyme stimulator Transplant rejection prednisone (oral, Inflammatory Glucocorticoid delayed release), disease; agonist Horizon/Mundiphar- Rheumatoid ma arthritis; Systemic lupus erythematosus cannabidiol (graft Graft versus host versus host disease disease), Kalytera Therapeutics ciclosporin (lipid Brain injury; Calcineurin emulsion, brain Myocardial inhibitor; Peptidyl- injury/myocardial infarction; prolyl cis-trans infarction), Traumatic brain isomerase D NeuroVive injury inhibitor Ampion Chronic Stem cell antigen- obstructive 1 inhibitor pulmonary disease; Crohns disease; Osteroarthritis LLDT-8 HIV infection; Rheumatoid arthritis tacrolimus Bone marrow Calcineurin transplantation; inhibitor Heart transplantation; IgA nephropathy; Kidney transplantation; Liver transplantation; Lung transplantation; Lupus nephritis; Myasthenia gravis; Pneumonia; Rheumatoid arthritis; Transplant rejection; Ulcerative colitis voclosporin Autoimmune Calcineurin disease; Kidney inhibitor; IL-2 transplant antagonist rejection; Lupus nephritis; Psoriasis; Renal disease; Transplant rejection; Uveitis

In some embodiments, the therapeutic agent is one of those in Table 4, below; or a pharmaceutically acceptable salt thereof.

TABLE 4 Exemplary Therapeutic Agents and Associated Diseases and Disorders Active Target-based Drug Name Indications Actions Structure YM-13650 L-683742 ruthenium complexes, Procept

PIC-060 analogs SC-114 oligomycin-F, Boehringer Mannheim L-755860 Potassium channel inhibitor NP-2214 pyrazole immunosuppressants, Abbott TAN-2178 IL-1 antagonist mycophenolic acid derivatives, Abbott L-732531 purine nucleoside Purine nucleoside phosphorylase phosphorylase inhibitors, Merrell inhibitor Dow p56Ick inhibitors (phenylaminopyrimidines), Celltech Zap70 tyrosine kinase inhibitor

T-cell modulators, Lund Research Center NE-501 cathepsin C Dipeptidyl inhibitors, Axys peptidase I inhibitor PIC-060 IML-1, Incyte Autoimmune disease; Multiple sclerosis; Transplant rejection Bi-51013 Fas delta therapy, LXR Biotechnology WF-10917 LXR-015-2 Carnitine palmitoyltransferase modulator CT-3578 ISP-I-55 interleukin-12 JAK tyrosine modulators kinase inhibitor (transplant rejection/autoimmune disease), Ligand DHODH inhibitors, Dehydrogenase Procept inhibitor SKF-105685 AlloMune Win-17317-3 Potassium channel inhibitor MC-1288 Vitamin D3 receptor agonist MC-1301 Vitamin D3 receptor agonist

specific HLA binding inhibitors, Avidex CKD-461 TAN-2451 analogs, Takeda IR-1116 TNFalpha-induced apoptosis inhibitors, Genzyme TNF alpha ligand inhibitor

roquinimex analogs, Fujisawa

B-975 TNF antagonist Lck kinase inhibitors, Boehringer Lck tyrosine kinase inhibitor

Xenocarb KF-20444 Dihydroorotate dehydrogenase inhibitor immune system regulator, Hollis- Eden Lck tyrosine kinase inhibitors, AstraZeneca Lck tyrosine kinase inhibitor

CD45 inhibitors, AstraZeneca CD45 antagonist; Protein tyrosine phosphatase inhibitor

LG293 inhibitors, Unspecified Lexicon enzyme inhibitor rapamycin mTOR inhibitor derivatives, SB ICAM-3 antibodies, Cell adhesion ICOS molecule inhibitor mRNA modulating agents, PTC Therapeutics

ZAP inhibitors, Zap70 tyrosine ARIAD kinase inhibitor NFAT transcription factor regulator, Abbott IL2 gene inhibitor; IL4 gene inhibitor; IL5 gene inhibitor; IL8 gene inhibitor

NIBR-0071 IL-2 antagonist; IL- 2 receptor alpha subunit inhibitor; TNF alpha ligand inhibitor SCH-204698 CD80 antagonist; T cell surface glycoprotein CD28 inhibitor ISP-1/myriocin analogs, Yoshitomi VLA-4 inhibitors, Integrin alpha- Novartis 4/beta-1 antagonist B7-1 inhibitors, Wyeth CD80 antagonist; Cytotoxic T- lymphocyte protein-4 inhibitor; T cell surface glycoprotein CD28 inhibitor

FR-901483 B-cell immunosuppressants (transplant rejection), Novartis

B-220

oral immunomodulators, Enzo radicicol derivatives, Kyowa Hsp 90 modulator

NSC-651016 CCR1 chemokine antagonist; CCR3 chemokine antagonist; CCR5 chemokine antagonist; CXCR4 chemokine antagonist IPL-423 series, Inflazyme transplantation therapy, 4SC CD46 cofactor, Complement Austin Research cascade inhibitor; Membrane cofactor protein modulator CXCR3 antagonist CXCR3 (transplant chemokine rejection), Merck & antagonist Co tyrosine Protein phosphatase phosphatase modulators modulator (allergy/autoimmune disease/cancer/trans- plant rejection), Cerylid Ick inhibitors, Abbott Lck tyrosine kinase inhibitor

Lck tyrosine kinase inhibitors, BMS Lck tyrosine kinase inhibitor

delta opioid Opioid receptor antagonists delta antagonist (immunosuppression), Adolor toxin based therapeutics, BRI Calcium channel inhibitor; Potassium channel inhibitor

TJU-103 interleukin-17 IL-17 receptor receptor, Immunex modulator KB-R7785 Matrix metalloprotease inhibitor VLA-4/VCAM Integrin alpha- antagonists 4/beta-1 (inflammation), antagonist; Elan/Wyeth Vascular cell adhesion protein 1 modulator VLA-4 inhibitors, Selectin Cytel antagonist T-cell receptor, CD3 agonist Procept CD4/CD2 inhibitors, Procept/Sandoz alpha-Gal PEG conjugates, Nextran Xenoject Allotrap-2702 4AZA-IS anti-inflammatories, Cell adhesion Genetics Institute molecule inhibitor; Phospholipase A2 inhibitor KRX-211 Jak3 tyrosine kinase inhibitor LFA-1 inhibitors CD11a antagonist; (autoimmune Integrin antagonist diseases), Tanabe/Novartis TSK-204 protein kinase C Protein kinase C modulators, Terrapin modulator ACEA-1021 NMDA glycine antagonist HMR-1279 Dihydroorotate dehydrogenase inhibitor immunosuppressant CD95 agonist; (CD95), CERES PARP inhibitor immunotherapy, ML Laboratories CCR5 antagonists (HIV/Transplant Rejection), Merck & Co CCR5 chemokine antagonist; CXCR5 chemokine antagonist

NP-005 FTA-2062 EP4 prostanoid receptor agonist TG-4 IMPDH II inhibitors, UCB Celltech Inosine monophosphate dehydrogenase 2 inhibitor

sirolimus (oral, mTOR inhibitor controlled-release, transplant rejection), LifeCycle Pharma PDE 7 inhibitors (autoimmune disease), BMS PDE 7 inhibitor

NK-10958P FR-260330 Inducible nitric oxide synthase inhibitor elsibucol Vascular cell adhesion protein 1 antagonist LJP-920 Genz-29155 TNF alpha ligand inhibitor zolimomab aritox podofilox derivatives, PharmaMar

AZ-4175 Prosorba Rheumatoid arthritis; Thrombocytopenic purpura IMPDH inhibitors Inosine (transplant monophosphate rejection/rheumatoid dehydrogenase athritis), c-a-i-r inhibitor biosciences monocarboxylate-1 Monocarboxylate transporter (MCT1) transporter-1 inhibitor (transplant inhibitor rejection), AstraZeneca apoptosis stimulators, Hughes Institute Jak3 tyrosine kinase inhibitor

JWH-015 Cannabinoid CB2 receptor agonist JWH-051 Cannabinoid CB2 receptor agonist; Cannabinoid receptor agonist O-823 Cannabinoid receptor agonist O-585 Cannabinoid receptor agonist; Cell adhesion molecule inhibitor O-689 Cannabinoid receptor agonist TKB-662 immunosuppressants (bone marrow- derived engineered veto cells, allogenic transplant rejection), Isogenis PD-184352 MEK-1 protein kinase inhibitor ZK-203278 Vitamin D3 receptor agonist ZK-261991 Kit tyrosine kinase inhibitor; VEGF-2 receptor antagonist; VEGF- 3 receptor antagonist interleukin-2 antagonists (graft- versus-host disease), Sunesis IL-2 antagonist EGS-21 Insulin sensitizer CCR5 antagonists, CCR5 chemokine Novartis antagonist alkaloidal immunosuppresants, C-TRI AD-412 Jak3 tyrosine kinase inhibitor JNKK modulators, Protein kinase Celgene inhibitor multimeric cell- Cell adhesion binding compounds molecule (cardiovascular stimulator disease/transplant rejection/renal failure/stroke), Repair Technologies BXL-01-0029 CXCL10 gene inhibitor BLNP-007 TAFA-93 mTOR inhibitor PG-140 CD86 antagonist PTL-101 TGF beta antagonist VR-909 azathioprine (oral liquid, rheumatoid arthritis/GVHD), DOR BioPharma R-524 Protein kinase C theta inhibitor AS-2643361 Inosine monophosphate dehydrogenase inhibitor mycophenolate Kidney transplant Inosine sodium (modified rejection monophosphate release tablets, dehydrogenase Kidney transplant inhibitor rejection), Panacea Biotec small molecule therapy (transplant rejection), SEEK Aom-0871 IKappaB kinase I-kappa B kinase (IKK) inhibitors, beta inhibitor BMS HPH-116 Allergy; Genital HIV p7 tract infection; nucleocapsid HIV infection; protein inhibitor; T- Inflammatory cell surface disease; glycoprotein CD8 Transplant modulator rejection CS-0777 Sphingosine-1- phosphate receptor-1 modulator NK-026680 Graft versus host disease immunomodulators, T Cell/Repligen TAQ-588 IL-4 antagonist; TNF alpha ligand inhibitor immunomodulators, Mycosearch/T Cell Sciences enisoprost Prostanoid receptor agonist

CWF-0808 Transplant rejection c-Rel inhibitors Autoimmune C-Rel proto- (cancer/inflammatory disease; Cancer; oncogene protein disease/autoimmune Inflammatory inhibitor diseases/transplantation disease; rejection), Transplant Cornell University rejection ciclosporin Calcineurin (aerosolized inhibitor liposomes, transplant rejection), Alulim tacrolimus (oral/FDT), Samyang Corp transmethylator inhibitor (oral, MS/transplant rejection) Digna Methyltransferase inhibitor

protein kinase C inhibitors (autoimmune disease/allograft injection), Novartis Institutes for BioMedical Research Protein kinase C delta inhibitor; Protein kinase C epsilon inhibitor; Protein kinase C eta inhibitor; Protein kinase C theta inhibitor

ETR-001 Complement cascade inhibitor AS-1896596 Histone deacetylase inhibitor SHIP inhibitors SH2 domain (GVHD/transplant inositol rejection), H Lee phosphatase Moffitt Cancer inhibitor Center and Research Institute KAR-2581 Histone deacetylase inhibitor NOX-100 Hypotension; Respiratory distress syndrome; Sepsis; Septic shock leflunomide (oral BK virus Dihydroorotate tablet, rheumatoid infection; Kidney dehydrogenase arthritis/lupus transplant inhibitor nerphritis/kidney rejection; Lupus transplant rejection), nephritis; Suzhou Rheumatoid Changzheng-Xinkai arthritis Pharmaceutical FFP-106 CD40 ligand inhibitor; CD40 ligand receptor antagonist AS-2521780 Protein kinase C theta inhibitor low molecular Islet cell weight dextran transplant sulfate (intravenous, rejection islet cell transplant rejection), TikoMed HS-378 Atopic dermatitis; Calcineurin Psoriasis; inhibitor; Opioid Rheumatoid receptor delta arthritis antagonist vasoactive intestinal Graft versus host VIP antagonist peptide antagonist disease (graft-vs-host disease), Emory University VEGFR3/VLA-1 Corneal CD49a antagonist; inhibitors (corneal transplant VEGF-3 receptor transplant rejection), rejection antagonist University of California at Berkeley BLHP-008 Erythema Glucocorticoid agonist p-ATT (type 1/2 Alpha 1 antitrypsin diabetes/influenza/ modulator; tuberculosis/anthrax/ Caspase-3 HIV inhibitor; Elastase infection/transplant inhibitor; rejection/GVHD), Interleukin-1 Omni Bio converting enzyme inhibitor; Serine protease inhibitor; Trypsin inhibitor immunomodulator (graft versus host disease/solid organ transplantation), Destum Partners Inc CXCR3 antagonists (autoimmune diseases), Ligand Pharmaceuticals/ Merck Research Laboratories CXCR3 chemokine antagonist

NYK-1341 Kidney transplant Hsp 70 stimulator rejection; Renal injury NF-kappaB subunit c-Rel inhibitors, ImmuneTarget Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Multiple myeloma; Multiple sclerosis; Organ transplantation C-Rel proto- oncogene protein inhibitor

mucosa-associated B-cell lymphoma; MALT protein 1 lymphoid tissue Cancer inhibitor; MALT lymphoma protein 1 translocation protein modulator 1 inhibitor (B-cell lymphoma), University of Lausanne/MRC Technology Jak-STAT signal JAK tyrosine transduction kinase inhibitor; pathway inhibitors STAT inhibitor (transplant rejection/autoimmune diseases), NHLBI tacrolimus Transplant Calcineurin (sustained release rejection inhibitor subcutaneous suspension, Plexis, graft rejection), Auritec eritoran TLR-4 antagonist Kv1.3 potassium channel blockers, AstraZeneca Potassium channel inhibitor

RTU-009, graft- Graft versus host Membrane copper versus-host disease disease amine oxidase inhibitor higher fatty acids (cancer/transplantation rejection), Xiamen University/Guangxi Normal University Cancer; Transplant rejection

dihydroorotate Dihydroorotate dehydrogenase dehydrogenase (DHODH) inhibitors inhibitor (oral, autoimmune disease/transplant rejection), H Lundbeck A/S IB-08C175 Multiple sclerosis LT-1945 BX-471 CCR1 chemokine antagonist synthetic cyclic AMP derivatives (immune disorders), Immune Modulation cAMP modulator

LT-1951 Graft versus host disease Iadarixin Insulin dependent CXCR1 diabetes chemokine antagonist; CXCR2 chemokine antagonist; IL-8 antagonist AER-270 Transplant Aquaporin 4 rejection inhibitor immunoproteasome inhibitor (transplant rejection), Harvard Medical School/Weill Cornell Medicine Transplant rejection Proteasome beta- 5 subunit inhibitor

MALT1 inhibitors MALT protein 1 (cancer/inflammation/ inhibitor; NF transplant kappa B activating rejection/autoimmune protein stimulator diseases), KU Leuven/Catholic University of Leuven/AstraZeneca R-548 Dermatological Jak3 tyrosine disease kinase inhibitor ulodesine Purine nucleoside phosphorylase inhibitor MRx-109 Rheumatoid arthritis; Transplantation KZR-616 Autoimmune Proteasome disease inhibitor JAK3 tyrosine kinase inhibitors (autoimmune disease, transplant rejection), Cytopia/Novartis Jak3 tyrosine kinase inhibitor

compound A (graft versus host disease), Theralogics IKK complex associated protein inhibitor NF-kB/AP-1 inhibitor, Tanabe AP1 transcription factor inhibitor; Nuclear factor kappa B inhibitor

RDP-58 IL12 gene inhibitor; Interferon gamma receptor antagonist; p38 MAP kinase inhibitor MRx-108 Transcription factor inhibitor bardoxolone (iv; Transcription inflammation, factor modulator; cancer), Reata Unspecified growth factor receptor modulator SUDCA, Axcan/CHRF elocalcitol Unspecified growth factor antagonist; Vitamin D3 receptor agonist transplant rejection therapy, Praxis XE-9 vidofludimus Autoimmune AKT1 gene disease; Crohns inhibitor; disease; Dihydroorotate Inflammatory dehydrogenase bowel disease; inhibitor; IL-17 Rheumatoid antagonist; JAK2 arthritis; Systemic gene inhibitor; lupus STAT3 gene erythematosus; inhibitor Transplant rejection; Ulcerative colitis autoimmune disease therapy, BEXEL Pharmaceuticals brequinar Dehydrogenase inhibitor brequinar analogs

Improx tresperimus cyclophosphamide (high dose, autoimmune disorders), Accentia tacrolimus (oral Graft versus host Calcineurin sustained-release), disease; Intestine inhibitor Astellas transplantation; Kidney transplant rejection; Liver transplant rejection; Transplant rejection C-87 Graft versus host TNF alpha ligand disease inhibitor GB-301 Corneal transplant rejection sotrastaurin Diffuse large B- Protein kinase C cell lymphoma; alpha inhibitor; Uveal melanoma Protein kinase C beta inhibitor; Protein kinase C delta inhibitor; Protein kinase C epsilon inhibitor; Protein kinase C eta inhibitor; Protein kinase C theta inhibitor APH-703 (iv, Alzheimers Protein kinase C Alzheimer's disease stimulator disease), Aphios NADPH oxidase Age related NADPH oxidase inhibitors (dry AMD), macular inhibitor Alimera degeneration mizoribine Lupus nephritis; Inosine Nephrotic monophosphate syndrome; dehydrogenase Rheumatoid inhibitor arthritis; Transplant rejection GCS-100 (iv, end Cell adhesion stage renal molecule inhibitor; disease/renal Galectin-3 inhibitor transplantation/cancer), La Jolla Pharmaceutical mocravimod Crohns disease; Sphingosine-1- dihydrochloride Graft versus host phosphate disease; receptor-1 agonist Transplant rejection RGI-2001 Graft versus host disease; Hemophilia; Lysosome storage disease reparixin Breast tumor; CXCR1 Cancer; Islet cell chemokine transplant antagonist; rejection; Kidney CXCR2 transplant chemokine rejection; Liver antagonist; IL-8 transplant antagonist rejection; Lung transplant rejection; Metastatic breast cancer TM-5509 Obesity; Stem cell transplantation; Transplant rejection lactobacillus Graft versus host plantarum strain disease 299v (GvHD), National Cancer Institute Lactobacillus Graft versus host plantarum strain 299 disease (graft versus host disease), National Cancer Institute CRAC inhibitors Autoimmune Ca2+ release (transplant disease; activated Ca2+ rejection/autoimmune Transplant channel 1 inhibitor disease), Johns rejection Hopkins University triciribine (iv, Acute AKT protein breast/ovarian myelogenous kinase inhibitor cancer/AML), leukemia; Breast Prescient tumor; Leukemia; Ovary tumor; Solid tumor gusperimus Lupus nephritis; Hsp 70 family trihydrochloride Transplant inhibitor rejection; Wegener granulomatosis tacrolimus Kidney transplant Calcineurin (improved tablet rejection; Liver inhibitor formulation), transplant Veloxis/Chiesi rejection fingolimod Multiple sclerosis; Cannabinoid Optic neuritis; receptor Rett syndrome; antagonist; Uveitis Sphingosine-1- phosphate receptor-1 modulator KD-025 Graft versus host IL-17 antagonist; disease; Rho associated Hepatocellular protein kinase 2 carcinoma; inhibitor Idiopathic pulmonary fibrosis; Lupus nephritis; Non- alcoholic steatohepatitis; Psoriasis; Rheumatoid arthritis; Spinal cord injury; Systemic lupus erythematosus peficitinib Dermatological JAK tyrosine disease; kinase inhibitor; Rheumatoid Jak1 tyrosine arthritis kinase inhibitor; Jak3 tyrosine kinase inhibitor cenicriviroc HIV associated CCR2 chemokine dementia; Liver antagonist; CCR5 fibrosis; Liver chemokine injury; Non antagonist alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Primary sclerosing cholangitis beclomethasone Crohns disease; Glucocorticoid dipropionate (oral, Enteritis; agonist acute radiation Gastrointestinal syndrome/Crohn's inflammation; Disease/radiation Radiation enteritis), Soligenix sickness; Ulcerative colitis dual aurora kinase Graft versus host Aurora protein A/JAK2 inhibitors disease kinase 2 inhibitor; (GvHD), H Lee Jak2 tyrosine Moffitt Cancer kinase inhibitor Center and Research Institute 2-Se-Cl Graft versus host P-Glycoprotein disease stimulator cannabidiol (graft Graft versus host versus host disease disease), Kalytera Therapeutics echinomycin Acute Hypoxia inducible (AML/GVHD), myelogenous factor inhibitor Oncolmmune leukemia; Graft versus host disease PKX-001 Dermatitis; Cell adhesion Inflammatory molecule inhibitor disease; Insulin dependent diabetes; Islet cell transplant rejection; Ocular inflammation peldesine Purine nucleoside phosphorylase inhibitor budesonide Colitis; Crohns Glucocorticoid (gastroresistant disease; agonist capsule, Crohn's Ulcerative colitis disease/ulcerative colitis), Dr Falk Pharma/Salix manitimus Dihydroorotate dehydrogenase inhibitor telmisartan (graft Graft versus host versus host disease disease), Hackensack University Medical Center arsenic trioxide Graft versus host (intravenous, disease; autoimmune Systemic lupus disease), Medsenic erythematosus HBI-002 Ischemic stroke; Kidney transplant rejection; Sickle cell anemia; Traumatic brain injury NFATc1 Graft versus host T-cell transcription SUMOylation disease factor NFAT1 blockers (GvHD), modulator Pfizer/Würzburg University/New York University School of Medicine pentostatin Chronic Adenosine lymphocytic deaminase leukemia; Hairy inhibitor cell leukemia emricasan (oral, islet Alcoholic Caspase inhibitor transplant hepatitis; rejection/liver Idiopathic disease), Novartis pulmonary fibrosis; Liver cirrhosis; Liver failure; Non- alcoholic steatohepatitis; Portal hypertension; Renal failure entospletinib Acute Syk tyrosine myelogenous kinase inhibitor leukemia; B-cell acute lymphoblastic leukemia; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Macroglobulinemia; Mantle cell lymphoma; Non-Hodgkin lymphoma everolimus Acute mTOR complex 1 lymphoblastic inhibitor; mTOR leukemia; inhibitor Advanced solid tumor; Angiomyolipoma; Astrocytoma; Bladder cancer; Breast tumor; Colorectal tumor; Cutaneous T-cell lymphoma; Diffuse large B- cell lymphoma; Endometrioid carcinoma; Epilepsy; Esophagus tumor; Glioma; Head and neck tumor; Heart transplant rejection; Kidney transplant rejection; Liver transplant rejection; Lung transplant rejection; Macroglobulinemia; Medullary thyroid cancer; Metastatic breast cancer; Metastatic renal cancer; Multiple hamartoma sydrome; Neuroendocrine tumor; Neurofibromatosis type I; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Pancreatic endocrine tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Thyroid tumor; Transplant rejection; Uveal melanoma IRX-4204 Alzheimers Beta amyloid disease; antagonist; Autoimmune Retinoid X encephalomyelitis; receptor agonist; Cancer; Graft Synuclein alpha versus host inhibitor; Tau disease; Multiple aggregation sclerosis; Non- inhibitor small-cell lung cancer; Parkinsons disease; Prostate tumor enteric-coated Kidney transplant Inosine mycophenolate rejection; Lupus monophosphate sodium, Novartis nephritis; dehydrogenase Nephrotic inhibitor syndrome pacritinib Acute CSF-1 antagonist; myelogenous Cytochrome P450 leukemia; reductase Chronic inhibitor; Flt3 lymphocytic tyrosine kinase leukemia; Graft inhibitor; IRAK-1 versus host protein kinase disease; inhibitor; Jak2 Myelofibrosis; tyrosine kinase Thrombocytopenia inhibitor momelotinib Jak1 tyrosine kinase inhibitor; Jak2 tyrosine kinase inhibitor; Serine threonine protein kinase TBK1 modulator panobinostat (oral), Advanced solid Cytochrome P450 Novartis tumor; Cancer; 2D6 inhibitor; Glioma; Graft Histone versus host deacetylase disease; HIV-1 inhibitor; Histone infection; deacetylase-1 Hormone inhibitor; Histone refractory deacetylase-2 prostate cancer; inhibitor; Histone Macroglobulinemia; deacetylase-3 Multiple inhibitor; Histone myeloma; deacetylase-6 Myelofibrosis; inhibitor; JAK2 Neuroendocrine gene inhibitor; tumor; Non- Orphan nuclear small-cell lung hormone receptor cancer; Sickle NR4A1 agonist cell anemia; Stage IV melanoma panobinostat Breast tumor; Histone (intravenous), Cancer; Graft deacetylase Novartis versus host inhibitor disease; Hormone refractory prostate cancer; Small-cell lung cancer itacitinib Advanced solid Jak1 tyrosine tumor; B-cell kinase inhibitor lymphoma; Diffuse large B- cell lymphoma; Graft versus host disease; Hodgkins disease; Myelofibrosis; Non-small-cell lung cancer; Pancreas tumor Acute Btk tyrosine myelogenous kinase inhibitor leukemia; Allergic rhinitis; Autoimmune disease; B-cell acute lymphoblastic leukemia; B-cell lymphoma; Breast tumor; Carcinoid tumor; Chronic lymphocytic leukemia; Colorectal tumor; Diffuse large B- cell lymphoma; Follicle center lymphoma; Graft versus host disease; Hairy cell leukemia; Lymphoplasmacy toid lymphoma; Macroglobulinemia; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastatic non small cell lung cancer; Metastatic renal cancer; Multiple myeloma; Neuroendocrine tumor; Non- Hodgkin lymphoma; Pancreas tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Systemic mastocytosis; T- cell lymphoma; Transitional cell carcinoma ruxolitinib (oral, Acute Jak1 tyrosine myeloproliferative lymphoblastic kinase inhibitor; disorders), leukemia; Acute Jak2 tyrosine Incyte/Novartis myelogenous kinase inhibitor leukemia; B-cell lymphoma; Breast disease; Cachexia; Chronic lymphocytic leukemia; Chronic myelocytic leukemia; Graft versus host disease; Head and neck tumor; Hodgkins disease; Leukemia; Metastatic breast cancer; Myelofibrosis; Polycythemia vera; Splenomegaly; T- cell lymphoma; Thalassemia major; Thrombocythemia nilotinib Acute Abl tyrosine lymphoblastic kinase inhibitor; leukemia; Acute Bcr protein myelogenous inhibitor; DDR leukemia; tyrosine kinase Alzheimers receptor inhibitor; disease; Cancer; Kit tyrosine kinase Chronic inhibitor; PDGF myelocytic receptor leukemia; Giant antagonist cell bone tumor; Glioma; Graft versus host disease; Lewy body dementia; Parkinsons disease; Pigmented villonodular synovitis pomalidomide AL amyloidosis; Cancer; Multiple myeloma; Myelofibrosis; Scleroderma bortezomib Acute 26S proteasome lymphoblastic complex inhibitor; leukemia; Acute Proteasome myelogenous inhibitor leukemia; Breast tumor; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Head and neck tumor; Hormone refractory prostate cancer; Kidney transplant rejection; Macroglo- bulinemia; Mantle cell lymphoma; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Solid tumor; Squamous cell carcinoma; Stage IV melanoma imatinib Acute Abl tyrosine lymphoblastic kinase inhibitor; leukemia; Bcr protein Aggressive inhibitor; Kit fibromatosis; tyrosine kinase Asthma; Chronic inhibitor; PDGF myelocytic receptor leukemia; antagonist; Signal Dermatofibro- transduction sarcoma; Gastrointestinal inhibitor stromal tumor; Hypereosinophilic syndrome; Myelodysplastic syndrome; Myeloid leukemia; Myeloproliferative disorder; Systemic mastocytosis tacrolimus Bone marrow Calcineurin transplantation; inhibitor Heart transplantation; IgA nephropathy; Kidney transplantation; Liver transplantation; Lung transplantation; Lupus nephritis; Myasthenia gravis; Pneumonia; Rheumatoid arthritis; Transplant rejection; Ulcerative colitis ponesimod Graft versus host Sphingosine-1- disease; Multiple phosphate sclerosis receptor-1 agonist tofacitinib citrate Discoid lupus JAK tyrosine (oral, inflammation), erythematosus; kinase inhibitor; Pfizer Juvenile Jak1 tyrosine rheumatoid kinase inhibitor; arthritis; Jak3 tyrosine Psoriasis; kinase inhibitor Psoriatic arthritis; Rheumatoid arthritis; Systemic lupus erythematosus; Ulcerative colitis sirolimus Chondrosarcoma; mTOR inhibitor Graft versus host disease; Kidney transplant rejection; Liposarcoma; Lymphangioleio- myomatosis; Systemic lupus erythematosus; Tuberous sclerosis mycophenolate Heart transplant Inosine mofetil rejection; IgA monophosphate nephropathy; dehydrogenase Interstitial lung inhibitor; PurH disease; Kidney purine transplant biosynthesis rejection; Liver protein inhibitor transplant rejection; Lung transplant rejection; Lupus nephritis; Pancreas transplant rejection; Pemphigus; Scleroderma; Transplant rejection Ozanimod Multiple sclerosis, Ulcerative colitis, Crohn's disease Piclidenoson Psoriasis, Rheumatoid arthritis, Glaucoma, Uveitis, Osteoarthritis, Dry eyes, Colorectal cancer, Solid tumours ABT 494 Rheumatoid arthritis, Crohn's disease, Ulcerative colitis, Atopic dermatitis Desoximetasone Plaque psoriasis, Atopic dermatitis Siponimod Multiple sclerosis, Polymyositis, Dermatomyositis, Renal failure, Liver failure Calcipotriol/betamet Plaque psoriasis, hasone dipropionate Psoriasis Forigerimod Systemic lupus erythematosus Masitinib Amyotrophic lateral sclerosis, Mastocytosis, Prostate cancer, Alzheimer's disease, Colorectal cancer, Malignant melanoma, Pancreatic cancer, Gastrointestinal stromal tumours, Multiple myeloma, Asthma, Peripheral T-cell lymphoma, Multiple sclerosis, Crohn's disease, Ovarian cancer, Progressive supranuclear palsy, Breast cancer, Chronic obstructive pulmonary disease, Non- small cell lung cancer, Mood disorders, Head and neck cancer, Glioblastoma, Hepatocellular carcinoma, Gastric cancer, Oesophageal cancer, Stroke, Psoriasis, Rheumatoid arthritis Filgotinib Rheumatoid arthritis, Crohn's disease, Ulcerative colitis Laquinimod Multiple sclerosis, Huntington's disease, Crohn's disease, Lupus nephritis, Systemic lupus erythematosus Baricitinib Rheumatoid arthritis, Systemic lupus erythematosus, Diabetic nephropathies, Atopic dermatitis, Psoriasis DFD 06 Plaque psoriasis Tazarotene/ Plaque psoriasis Ulobetasol Calcipotriol Plaque psoriasis, Psoriasis Clobetasol Atopic dermatitis, propionate Psoriasis, Skin disorders DFD 01 Plaque psoriasis Pefcalcitol Plaque psoriasis, Palmoplantar keratoderma ALKS 8700 Multiple sclerosis Calcitriol Plaque psoriasis

In some embodiments, the therapeutic agent is one of those in Table 5, below; or a pharmaceutically acceptable salt thereof.

TABLE 5 Exemplary Therapeutic Agents and Associated Diseases and Disorders Drug Name Active Indications Target-based Actions Structure HS-026 fomitellan A immunostimulant, InKine sizofiran Uterine cervix tumor Jenact ANA-971 TLR-7 modulator acemannan HIV infection; Wound healing Interferon gamma receptor agonist ANA-975 TLR-7 modulator MNLP-24 Phellinus linteus derivative (cancer), Il-Yang icadamine B (viral infection/ cancer/immune diseases), Cornell Phytomix-40 Interferon agonist KLH (bladder tumor), Intracel MM-15-01 OM-294-DP TLR-4 agonist OM-197-MP-AC TLR-4 agonist Dendrigen SL cytokine ligand beta glucan/lectin combination drug (cancer), Metabolic Research CMP-1 SMT-14400 KLH/IMG Vaccination BCG polysaccharide and nucleic Asthma; Chronic bronchitis; Common cold acid, Zhejiang Wanma Pharmaceutical Chemical KLH/SUBUNIT Vaccination BCG polysaccharide and nucleic Allergy; Asthma; Cancer; Chronic bronchitis; acid, Jilin Yatai Common cold; Immune complex disease; Bio-Pharmaceutical Infectious disease polysaccharide vaccine Pneumonia (antigen-specific immune cell activation technolotgy, pneumonia), Haikou BCV-01 oglufanide disodium Bacterial infection; Viral infection (intranasal, infectious diseases), Implicit Bioscience AMZ-0026-H plant-derived immunostimulators (vaccination), BioStrategies Ochrobactrum intermedium Sepsis TLR-2 agonist; TLR-4 LPS (sepsis), Diomune agonist S4 (peptides, immune diseases), Entopharm picroliv Liver disease VSSP (adjuvant/HIV/ HIV infection; Renal tumor; Vaccination cancer), Center of Molecular Immunology BLI-1301 Myelodysplastic syndrome CEL-1000 Cancer; Immune disorder; Infectious disease ISCOMATRIX Vaccination JVRS-100 Leukemia; Radiation sickness; TLR modulator Reperfusion injury; Vaccination P-MAPA Bladder cancer; Mycobacterium tuberculosis TLR-2 agonist; TLR-4 infection; Zika virus infection agonist Arthrobotrys oligospora Cancer derived nanoparticles (cancer), University of Tennessee AMZ-0026 AS-210 Mycobacterium brumae Bladder cancer immunotherapy (bladder cancer), Universitat Autonoma de Barcelona TR-987 Diabetic foot ulcer; Skin burns; Varicosis C-type lectin domain ulcer; Wound healing protein 7A modulator; TLR-2 modulator beta-1,3/1,6-glucan, Allergy; Breast tumor; Inflammatory bowel Biotec Pharmacon disease; Neuroblastoma; Non-Hodgkin lymphoma EG-Vac Infectious disease; Vaccination AF-122 Cancer Liver X receptor modulator lentinan (stabilized powder Cancer; Infectious disease; Non-small-cell Integrin alpha-M/beta-2 formulation), GlycaNova lung cancer modulator QS-21 Vaccination MPL-containing Pollinex Allergy allergy desensitization sublingual vaccine (grass), Allergy Therapeutics Acarovac Plus Allergy Ragweed MATA MPL Allergy TLR agonist AS-01 adjuvant Vaccination AGI-134 Cancer selumetinib + durvalumab Solid tumor MEK-1 protein kinase (solid tumors), AstraZeneca inhibitor; MEK-2 protein kinase inhibitor; Programmed cell death ligand 1 inhibitor inarigivir soproxil Hepatitis B virus infection; Hepatitis D virus NOD2 gene stimulator; infection Retinoic acid-inducible gene 1 stimulator TLR2 agonist (infection), Infectious disease TLR-2 agonist Innavac Poly-ICLC Cancer; Glioma; Metastatic colon cancer; Interferon agonist; Metastatic pancreas cancer; Non-Hodgkin lymphoma; TLR-3 agonist Solid tumor; Stroke; Viral infection trabectedin + durvalumab (iv, Ovary tumor; Soft tissue sarcoma Programmed cell death ovarian cancer/soft tissue ligand 1 inhibitor sarcoma), AstraZeneca/ PharmaMar IMM-60, iOx Therapeutics/ Cancer University of Oxford/Ludwig Institute For Cancer Researc docetaxel Breast tumor; Cancer; Endometrioid carcinoma; Esophagus tumor; Head and neck tumor; Hormone refractory prostate cancer; Metastatic breast cancer; Metastatic non small cell lung cancer; Metastatic stomach cancer; Nasopharyngeal carcinoma; Non-small-cell lung cancer; Ovary tumor; Paranasal sinus disease; Prostate tumor; Squamous cell carcinoma; Stomach tumor plinabulin Cancer; Febrile neutropenia; Non-small-cell Guanine nucleotide lung cancer exchange factor stimulator; Tubulin antagonist NANT Ovarian Cancer Vaccine Ovary tumor Acyltransferase inhibitor; Brachyury protein modulator; CD66 modulator; Erbb2 tyrosine kinase receptor modulator; Estrogen receptor antagonist; IL-15 agonist; IL-15 receptor modulator; Mucin 1 modulator; Programmed cell death ligand 1 inhibitor; Ras GTPase modulator; Thymidylate synthase inhibitor; VEGF ligand inhibitor NANT Non-small Cell Lung Non-small-cell lung cancer Acyltransferase inhibitor; Cancer Vaccine Brachyury protein modulator; CD66 modulator; Erbb2 tyrosine kinase receptor modulator; Estrogen receptor antagonist; IL-15 agonist; Mucin 1 modulator; Programmed cell death ligand 1 inhibitor; Programmed cell death protein 1 inhibitor; Ras GTPase modulator; Thymidylate synthase inhibitor; VEGF ligand inhibitor Pollinex Quattro Birch Allergy Grass MATA MPL Allergy

In some embodiments, the therapeutic agent is one of those in Table 6, below; or a pharmaceutically acceptable salt thereof.

TABLE 6 Exemplary Therapeutic Agents and Associated Diseases and Disorders Active Target-based Drug Name Indications Actions Structure FR-111142 1069C85 purine nucleoside Purine nucleoside phosphorylase phosphorylase inhibitors, Merrell inhibitor Dow SA-450 Glucocorticoid agonist retinoid receptor agonists, Chinese Academy of Sciences

enloplatin MC-1288 Vitamin D3 receptor agonist lexacalcitol Vitamin D3 receptor agonist MM-014 CC-394 KT-5720 Protein kinase A inhibitor SA-47 N,N-disubstituted alanine, Ortho McNeil Sphingomyelinase inhibitor

PSK-3668 Estrogen receptor antagonist tyrosine kinase Btk tyrosine inhibitor, Hughes kinase inhibitor Institute TXU-PAP, Hughes Institute sobuzoxane Leukemia; Non- DNA gyrase Hodgkin inhibitor; lymphoma Topoisomerase II inhibitor ALRT-1455 Retinoic acid receptor alpha agonist ALRT-792 Retinoic acid receptor agonist; Retinoid X receptor agonist JAK tyrosine kinase JAK tyrosine inhibitors (cancer), kinase inhibitor Cephalon anticancer therapy, SuperGen IL-6 trap, Regeneron IL-6 antagonist SR-271425 DNA gyrase inhibitor; Topoisomerase II inhibitor SDX-101 Beta-catenin inhibitor; Nuclear factor kappa B inhibitor; PPAR gamma agonist phosphonate Phospholipase C inhibitor menogaril skeletal targeted radiotherapy, NeoRx CT-32228 Lysophosphatidic acid actyltransferase inhibitor adenosine deaminase inhibitors, Astellas Adenosine deaminase inhibitor

farnesyl transferase inhibitos (multiple myeloma), University of South Florida/H Lee Moffitt Cancer Center Protein farnesyltransferase inhibitor; Ras GTPase inhibitor

phorboxaole A (acute lymphoblastic leukamia/multiple myelome), Hughes Institute phenylmorphans, NIH Sigma opioid receptor agonist

Ki-4, dgA semaxanib Aryl hydrocarbon receptor agonist; MAP kinase inhibitor; VEGF-2 receptor antagonist galarubicin Metalloprotease-2 inhibitor; Metalloprotease-9 inhibitor; Metalloproteinase inhibitor-1 inhibitor; Metalloproteinase inhibitor-2 inhibitor AE-941 Metalloprotease- 12 inhibitor; Metalloprotease-2 inhibitor; Metalloprotease-9 inhibitor; Tissue plasminogen activator modulator; VEGF receptor antagonist sardomozide S- adenosylmethionine decarboxylase inhibitor imexon (injectable, Enhanced Prodrug), Heidelberg Pharma PS-031291 CCR1 chemokine antagonist mitoguazone epirubicin (Biotransport), Supratek eheofazine AR-623 SR-45023A ACAT inhhibitor; Farnesoid X receptor agonist T-607 Tubuline binding agent L-OddU GSK-461364 Polo-like kinase 1 inhibitor; Polo-like kinase 3 inhibitor didemnin B talmapimod p38 MAP kinase inhibitor AEW-541 Insulin-like growth factor 1 antagonist PPI-2458 Aminopeptidase inhibitor TAE-684 ALK tyrosine kinase receptor family inhibitor UCL-67022 Histone deacetylase-6 inhibitor JNKK modulators, Protein kinase Celgene inhibitor lestaurtinib Flt3 tyrosine kinase inhibitor; Jak2 tyrosine kinase inhibitor; TrkA receptor antagonist VEGF-D inhibitors VEGF-D ligand (lumphangioleiomyo- inhibitor matosis), Circadian Technologies SCIO-323 p38 MAP kinase inhibitor fluphenazine 5-HT 1b receptor (multiple antagonist myeloma/psoriasis), Corridor Pharmaceuticals [(CD20)2xCD16] B-lymphocyte antigen CD20 modulator; Immunoglobulin gamma Fc receptor IIIA modulator interleukin-2 Itk tyrosine kinase inducible tyrosine inhibitor kinase inhibitors (T- cell lymphoma), MannKind GDC-0349 mTOR inhibitor CCX-721 CCR1 chemokine antagonist lexibulin (iv infusion, Tubulin binding cancer), YM agent BioSciences etoposide Topoisomerase II (Biotransport), inhibitor Supratek Entelon Lymphatic system disease; Osteoarthritis PBOX apoptosis inducers, Trinity College/University of Siena

PI3K delta kinase Phosphoinositide- inhibitors (B-cell 3 kinase delta lymphomas/ inhibitor rheumatoid arthritis/asthma/ COPD), Incozen Therapeutics ITK inhibitors (cancer), University of California Davis Itk tyrosine kinase inhibitor

CYB5B modulators Cytochrome B5 (lymphoma), BC modulator Cancer Agency valspodar lexibulin (oral Tubulin binding capsule, cancer), agent YM Biosciences XL-228 Abl tyrosine kinase inhibitor; Aurora protein kinase inhibitor; Insulin-like growth factor 1 antagonist; Insulin-like growth factor 1 recptor moculator; Src tyrosine kinase inhibitor tasisulam TP-1149 alitretinoin Kaposis sarcoma Retinoid X receptor modulator immunotoxin Adult T-cell (autoimmune lymphoma; diseases/leukemias/ Autoimmune lymphomas), disease; NIMH/NIH OTT Cutaneous T-cell lymphoma combination therapy Adenosine A2a with evodenoson receptor agonist (anticancer, multiple myeloma), CombinatoRx SOM-0350 litonesib Kinesin-like protein KIF11 inhibitor small molecule therapeutics (multiple myeloma), Array BioPharma cathepsin K Cathepsin K inhibitors (multiple inhibitor myeloma/bone disease), ONO Pharmaceuticals ONO-WG-307 Btk tyrosine kinase inhibitor next generation EVB Thymidine kinase TK gene expression stimulator stimulators (cancer), Phoenicia Biosciences MLN-0905 Polo-like kinase 1 inhibitor ridaforolimus mTOR inhibitor (intravenous), Merck & Co deuterated lenalidomide, Deuteria Pharmaceuticals ALK inhibitors (anaplastic large cell lymphoma), Cephalon Anaplastic lymphoma kinase receptor inhibitor

OTJ Hypercalcemia; Multiple myeloma; Ostealgia; Osteoporosis; Pagets bone disease KW-2478 Hematological Hsp 90 inhibitor neoplasm; Multiple myeloma SOM-0666 DHFR inhibitor; Folate antagonist rabacfosadine DNA polymerase inhibitor motexafin Thioredoxin gadolinium reductase modulator small molecule compounds (multiple myeloma), University of Technology Sydney Epstein-Barr virus Infectious Complement targeting program mononucleosis receptor 2 (infectious modulator mononucleosis), Molplex Pharmaceuticals delta-opioid receptor Multiple Opioid receptor ligands (cancer), myeloma delta modulator Rutgers university Pim kinase inhibitors (cancer), Genentech Multiple myeloma PIM protein kinase inhibitor

AKR-302 repurposed Epstein Barr virus NKG2D ligand pamidronic acid infection; modulator (EBV-induced B cell Lymphopro- lymphoproliferative liferative disorders), The diasease University of Hong Kong canfosfamide Breast tumor; Glutathione S- Colon tumor; transferase P Diffuse large B- modulator cell lymphoma; Lung tumor; Mantle cell lymphoma; Multiple myeloma; Non- small-cell lung cancer; Ovary tumor QIN-1 Nuclear factor kappa B inhibitor SB-743921 Kinesin-like protein KIF11 inhibitor cutaneous T cell lymphoma therapeutics, BC Cancer Agency silicon phthalocyanine 4 + photodynamic therapy (T-cell non- Hodgkin lymphoma), NCI DNX-5000 series Focal adhesion kinase inhibitor; Focal adhesion kinase-2 inhibitor BI-2536 Polo-like kinase 1 inhibitor tyrosine kinase Protein tyrosine inhibitors (non- kinase inhibitor Hodgkins lymphoma), Hospital Clinic of Barcelona/Fundacio Clinic proteasome inhibitors (multiple myeloma), Evestra Proteasome inhibitor

GRK6 inhibitors GRK6 protein (multiple myeloma), kinase inhibitor Mayo Clinic small molecule therapeutic (oral, Castleman's disease/Kaposi's sarcoma/primary effusion lymphoma), Ascepion Pharmaceuticals A-1014907 Aurora protein kinase inhibitor; VEGF receptor antagonist microtubule T-cell lymphoma depolymerization inducer (T-cell lymphoma), Inje University epigenetic monoclonal induction therapy (cancer), Nimble Epitech P-276-00 Cyclin D1 inhibitor; Cyclin T inhibitor; Cyclin-dependent kinase inhibitor 1B inhibitor; Cyclin- dependent kinase- 4 inhibitor; Cyclin- dependent kinase- 9 inhibitor delanzomib Immunoglobulin G antagonist; Proteasome inhibitor LC-530110 Multiple myeloma Proteasome inhibitor TP-110, Microbial Proteasome Chemistry Research inhibitor Foundation thalidomide (multiple Erythema myeloma), Fujimoto nodosum leprae; Multiple myeloma; POEMS syndrome gallium nitrate Hypercalcemia PM-00104/50 P-Glycoprotein 1 inhibitor; Transcription factor inhibitor CVXL-0102 Jak3 tyrosine kinase inhibitor; Syk tyrosine kinase inhibitor EDE-1206 Elephantiasis PRT-2607 Allergy; Cancer; Syk tyrosine Chronic kinase inhibitor lymphocytic leukemia; Inflammatory disease; Non- Hodgkin lymphoma; Rheumatoid arthritis; Systemic lupus erythematosus PKC-theta inhibitors (inflammatory/auto- immune disease/cancer), CompleGen Autoimmune disease; HIV infection; Inflammatory disease; T-cell lymphoma Protein kinase C theta inhibitor

perk kinase Multiple myeloma Proline rich inhibitors (multiple receptor like myeloma), New kinase PERK York University inhibitor EP-009 Jak3 tyrosine kinase inhibitor immunoglobulin Immunoglobulin G heavy chain gene antagonist enhancer inhibitors (multiple myeloma), Leukogene Therapeutics ASP-4132 Advanced solid tumor; Lymphoma NFkB inhibitors Diffuse large B- Nuclear factor (diffuse large B-cell cell lymphoma kappa B inhibitor lymphoma), University of Rochester SHIP-1 inhibitors Multiple myeloma INPP5D gene (multiple myeloma), inhibitor Upstate Medical University MKC-204 Multiple IRE1 protein myeloma kinase inhibitor boanmycin Liver tumor; hydrochloride (im/iv, Lymphoma; esophageal Metastatic cancer/liver esophageal cancer/lymphoma), cancer Liaoyuan Dikang Pharmaceutical fluorinonide Atopic dermatitis; (topical), Medicis Contact dermatitis; Mycosis fungoides; Pruritus; Psoriasis hybrid compounds (multiple myeloma), Virginia Commonwealth University BLHP-007 Head and neck tumor; Hodgkins disease BLHP-001 CSA-92

Btk covalent irreversible inhibitors (lymphoma), Peking University Lymphoma Btk tyrosine kinase inhibitor

SOM-0558 STK-405759 Multiple myeloma SRI-31277 Fibrosis; Multiple Thrombospondin- myeloma 1 ligand inhibitor S-6810 DS-3078 mTOR complex 1 inhibitor; mTOR complex 2 inhibitor BEBT-908 Cancer; Chronic Histone lymphocytic deacetylase leukemia; inhibitor; Lymphoma; Phosphoinositide Multiple myeloma 3-kinase inhibitor JAK2 inhibitors Lymphoma Jak2 tyrosine (lymphoma), kinase inhibitor University of Iowa DRX-254 Multiple myeloma Btk inhibitors (B-cell B-cell lymphoma Btk tyrosine lymphoma), National kinase inhibitor Health Research Institutes NF-kappaB subunit c-Rel inhibitors, Immune Target Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Multiple myeloma; Multiple sclerosis; Organ transplantation C-Rel proto- oncogene protein inhibitor

IL-6 inhibitors (oral, Cachexia; IL-6 antagonist inflammation/Castle- Castlemans mans disease; disease/cachexia), Inflammatory Interprotein/RIKEN disease prednisolone Lymphoma (malignant lymphoma), Shionogi MI-2 Diffuse large B- MALT protein 1 cell lymphoma inhibitor Btk inhibitors (autoimmune diseases), Genentech/Gilead Autoimmune disease; B-cell lymphoma Btk tyrosine kinase Inhibitor

HDAC inhibitor Hemoglobin (hemoglobinopathy), modulator; Italfarmaco Histone deacetylase-1 inhibitor; Histone deacetylase-2 inhibitor; Histone deacetylase-4 inhibitor TAS-5567 Syk tyrosine kinase inhibitor mucosa-associated B-cell lymphoma; MALT protein 1 lymphoid tissue Cancer inhibitor; MALT lymphoma protein 1 translocation protein modulator 1 inhibitor (B-cell lymphoma), University of Lausanne/MRC Technology JNJ-40646527 CSF-1 antagonist Q-203, QUE Oncology ML-319 Chronic Btk tyrosine lymphocytic kinase inhibitor leukemia; Mantle cell lymphoma; Non-Hodgkin lymphoma CCX-354 Bone CCR1 chemokine metastases; antagonist Multiple myeloma; Rheumatoid arthritis ZYBT-1 Arthritis; Diffuse Btk tyrosine large B-cell kinase inhibitor lymphoma daniquidone Topoisomerase I inhibitor; Topoisomerase II inhibitor bone targeted epigenetic drugs (multiple myeloma), Episynesis X-022 Autoimmune Btk tyrosine disease; B-cell kinase inhibitor lymphome second generation Multiple myeloma Extracellular program, Kesios signal related Therapeutics kinase-5 inhibitor; GADD45B gene inhibitor linsitinib Insulin receptor antagonist; Insulin-like growth factor 1 antagonist canavanine, Multiple Multiple myeloma Myeloma muparfostat sodium Hepatocellular FGF receptor carcinoma antagonist; FGF-1 ligand inhibitor; FGF-2 ligand inhibitor; Heparanase inhibitor; VEGF receptor antagonist CU-042 Diffuse large B- Nuclear factor cell lymphoma kappa B inhibitor immunomodulators Lymphoma; Solid (lymphoma/solid tumor tumor), Alligator bioscience/Stanford University obatoclax Bcl-2 protein inhibitor; Mcl-1 differentiation protein inhibitor FV-214 Macroglobulinemia; Chymotrypsin Multiple inhibitor; myeloma Proteasome inhibitor FV-162 Macroglo- Chymotrypsin bulinemia; inhibitor; Multiple Proteasome myeloma inhibitor luminespib Cancer ATPase inhibitor; Hsp 90 inhibitor dexamethasone Multiple myeloma Glucocorticoid acetate (high-dose agonist formulation, multiple myeloma), Laboratories CTRS NK-012 Breast tumor; Topoisomerase I Colorectal tumor; inhibitor Multiple myeloma; Small- cell lung cancer CYF-2-11 B-cell lymphoma imexon (injectable), Hypoxia inducible AmpliMed factor-1 alpha inhibitor; Ribonucleotide reductase inhibitor CXCR5 inhibitors (T- Angioimmuno- CXCR5 cell lymphoma), blastic T-cell chemokine Yale University lymphoma antagonist CCX-9588 Cancer CCR1 chemokine antagonist SCFV-based Leukemia; chimeric antigen Lymphoma receptors (leukemia/ lymphoma), Lentigen Technology SG-2000 Lymphoma curcumin-ND Mantle cell (mantle cell lymphoma lymphoma), Lypro HDAC 6/8 inhibitors Histone (multiple deacetylase-6 myeloma/neuro- inhibitor; Histone blastoma), deacetylase-8 Kancera AB inhibitor diazeniumdiolate NO releasing compounds (cancer), JSK Therapeutics

4SC-205 Cancer; Kinesin-like Lymphoma; Solid protein KIF11 tumor inhibitor TORC2 inhibitors Multiple myeloma mTOR complex 2 (multiple myeloma), inhibitor VA Greater Los Angeles DRGT-54 JAK1 kinase Lymphoma Jak1 tyrosine inhibitors, Cloud kinase inhibitor Pharmaceuticals HDAC8 inhibitor (T T-cell-lymphoma Histone cell lymphoma), deacetylase-8 Cloud inhibitor Pharmaceuticals antielephantiasis therapy, Anacor RG-7602 Checkpoint kinase 1 inhibitor VDA-1102 Cutaneous T-cell Hexokinase 2 lymphoma; modulator; Keratosis; Voltage Squamous cell dependent anion carcinoma channel modulator SIRT2 inhibitors (B- B-cell lymphoma NAD-dependent cell lymphoma), deacetylase Fred Hutchinson sirtuin-2 inhibitor Cancer Research Center SPARC-147709 sepantronium Survivin protein bromide inhibitor modified formulation Proteasome of bortezomib inhibitor (solution for injection, multiple myeloma), InnoPharma pictilisib NOTCH1 gene inhibitor; Phosphoinositide- 3 kinase alpha inhibitor darinaparsin (oral, Cancer cancer), Solasia Pharma palifosfamide Cancer acadesine AMP activated (intravenous, protein kinase prodrug, B- stimulator CLL/MM/MCL), Advancell 2-methoxyestradiol, Multiple sclerosis; Hypoxia inducible CASI Rheumatoid factor-1 inhibitor; Pharmaceuticals arthritis VEGF receptor antagonist leukotriene B4 Lymphedema; inhibitor Pulmonary artery (PAH/lymphedema), hypertension Eiger BioPharmaceuticals IRAK4 inhibitors Autoimmune IRAK-4 protein (lymphoma/ disease; Diffuse inflammatory large B-cell disorders), Genentech lymphoma; Inflammatory disease GT-1036 Apoliproprotein E agonist; Retinold X receptor agonist noscapine (cancer), Tubulin binding Cougar agent rHuEPO (multiple Multiple myeloma Erythropoietin myeloma), XTL receptor agonist avicin D (multiple Mantle cell myeloma), Avicin lymphoma; Therapeutics Multiple myeloma perifosine Cancer; AKT protein Colorectal tumor; kinase inhibitor; Glioma; Multiple Phosphoinositide myeloma 3-kinase inhibitor elsamitrucin DNA gyrase inhibitor; Topoisomerase I inhibitor; Topoisomerase II inhibitor CUDC-427 Lymphoma; Solid X-linked inhibitor tumor of apoptosis protein inhibitor cladribine Chronic Adenosine lymphocytic deaminase leukemia; Hairy inhibitor cell leukemia AT-101 Chronic Bcl-xL Bcl-2 lymphocytic associated death leukemia; promotor inhibitor; Esophagus Mcl-1 tumor; Glioma; differentiation Hormone protein inhibitor refractory prostate cancer; Larynx tumor; Multiple myeloma; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Small-cell lung cancer banoxantrone Topoisomerase II inhibitor CX-1001 + Serotonin undisclosed transporter anticancer therapy stimulator (B-cell cancer), Celentyx CX-1001 Serotonin transporter stimulator safingol Lymphoma; Solid Protein kinase C tumor inhibitor DTRMWXHS-12 lymphoma Btk tyrosine kinase inhibitor dinaciclib Cyclin-dependent kinase-1 inhibitor; Cyclin-dependent kinase-2 inhibitor; Cyclin-dependent kinase-5- inhibitor; Cyclin-dependent kinase-9 inhibitor SNS-032 Cyclin-dependent kinase-2 inhibitor; Cyclin-dependent kinase-7 inhibitor; Cyclin-dependent kinase-9 inhibitor IPH-1101 talabostat Chronic Dipeptidyl Lymphocytic peptidase IV leukemia; inhibitor; Hematological Dipeptidyl disease; peptidase IX Melanoma; inhibitor; Neutropenia; Dipeptidyl Non-Hodgkin peptidase VIII lymphoma; Non- inhibitor; Seprase small-cell lung inhibitor cancer; Pancreas tumor; Renal tumor RH-1 thymocartin AR-726 DNA binding protein modulator STF-083010 ERN1 gene modulator tanespimycin Cancer; Thyroid Hsp 90 inhibitor; tumor MET tyrosine kinase receptor family inhibitor JNJ-40346527 CSF-1 antagonist doxorubicin Breast tumor; DNA polymerase hydrochloride Cancer; Kaposis inhibitor; (liposomal sarcoma; Multiple Topoisomerase II formulation, cancer), myeloma; Ovary inhibitor TTY Biopharm tumor IQS-019 Non-Hodgkin Bcr protein lymphoma inhibitor MCLA-114 CD3 modulator BET inhibitors Bromodomain (cancer), Zenith containing protein Epigenetics inhibitor; MYC gene inhibitor daporinad Nicotinamide phosphoribosyltrans- ferase inhibitor cefotiam Abscess; Acute bronchitis; Bacterial infection; Bacterial meningitis; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Cholangitis; Cholecystitis; Corneal ulcer; Cystitis; Dacryocystitis; Empyema; Female genital tract infection; Infectious arthritis; Keratitis; Laryngo- pharyngitis; Lympha- denopathy; Mastitis; Ocular infection; Osteomyelitis; Otitis media; Peritonitis; Prostatitis; Pyelonephritis; Sepsis; Sinusitis; Tonsillitis; Urethritis BAY-1862864 Non-Hodgkin B-lymphocyte cell lymphoma adhesion molecule inhibitor FAB-114 Chronic lymphocytic leukemia; Non- Hodgkin lymphoma sonidegib (oral), Acute Hedgehog protein Novartis myelogenous inhibitor; leukemia; Basal Smoothened cell carcinoma; receptor Basal cell nevus antagonist syndrome; Chronic myelocytic leukemia; Hematological neoplasm; Multiple myeloma; Myelodysplastic syndrome; Myelofibrosis; Pancreas tumor PERK-selective Proline rich kinase inhibitors receptor like (multiple kinase PERK myeloma/B-cell inhibitor lymphoma), Janssen Research and Development samarium(153Sm) Cancer; Pain lexidronam BNV-215 beta-1,3/1,6-glucan, Allergy; Breast Biotec Pharmacon tumor; Inflammatory bowel disease; Neuroblastoma; Non-Hodgkin lymphoma KRX-0402 Cancer; O-methylguanine Cutaneous T-cell DNA lymphoma methyltransferase inhibitor entasobulin Topoisomerase II inhibitor; Tubulin beta inhibitor BTK inhibitors (B- Autoimmune Btk tyrosine cell disease; B-cell kinase inhibitor lymphomas/ lymphoma autoimmune disease), Eternity Bioscience reformulated Elephantiasis; flubendazole Onchocerciasis (elephantiasis/river blindness), J&J/ Drugs for Neglected Diseases initiative GDC-0575 Lymphoma; Solid Checkpoint kinase tumor 1 inhibitor radiolabeled Multiple myeloma CXCR4 gene pentixather (multiple modulator myeloma), University of Wurzburg/Technical University of Munich spebrutinib Autoimmune Btk tyrosine disease; Chronic kinase inhibitor lymphocytic leukemia; Diffuse large B-cell lymphoma; Multiple myeloma; Non- Hodgkin lymphoma; Rheumatoid arthritis CC-223 mTOR complex 1 inhibitor; mTOR complex 2 inhibitor doxorubicin DNA polymerase (liposome- inhibitor; encapsulated), Topoisomerase II NeoPharm inhibitor CPI-0610 Acute leukemia; Bromodomain Autoimmune containing protein disease; Cystic 4 inhibitor; fibrosis; Bromodomain Lymphoma; containing protein Mantle cell inhibitor; Myc lymphoma; proto-oncogene Multiple protein inhibitor myeloma; Myelodysplastic syndrome voxtalisib Phosphoinositide 3-kinase inhibitor; mTOR inhibitor sotrastaurin Diffuse large B- Protein kinase C cell lymphoma; alpha inhibitor; Uveal melanoma Protein kinase C beta inhibitor; Protein kinase C delta inhibitor; Protein kinase C epsilon inhibitor; Protein kinase C eta inhibitor; Protein kinase C theta inhibitor REM-1086 Multiple Nuclear factor myeloma; kappa B Rheumatoid modulator; arthritis; Spinal Nuclear factor cord disease keppa B p105 inhibitor; Transcription factor RelB inhibitor; Transcription factor p65 inhibitor clofarabine (oral), Genzyme SH-7113 B-cell lymphoma; Unspecified Leukemia receptor modulator SH-7133 B-cell lymphoma; Unspecified Leukemia receptor modulator FROST-600 Mantel cell lymphoma GS-9820 Phosphoinositide- 3 kinase beta inhibitor; Phosphoinositide- 3 kinase delta inhibitor voruciclib Cancer Cyclin dependent kinase 4 inhibitor D inhibitor; Cyclin- dependent kinase inhibitor 1B inhibitor; Cyclin- dependent kinase- 4 inhibitor; Cyclin- dependent kinase- 9 inhibitor filanesib Multiple myeloma Kinesin-like protein KIF11 inhibitor apitolisib Phosphoinositide 3-kinase inhibitor; mTOR complex 1 inhibitor; mTOR complex 2 inhibitor TACE inhibitors Inflammatory TACE inhibitor (inflammatory disease diseases), Allosterix GS-5829 Advanced solid Bromodomain tumor; Hormone containing protein refractory inhibitor prostate cancer; Lymphoma; Metastatic breast cancer GCS-100 (iv, end Cell adhesion stage renal molecule inhibitor; disease/renal Galectin-3 inhibitor transplantation/cancer), La Jolia Pharmaceutical ASTX-660 Advanced solid Inhibitor of tumor; Cancer; apoptosis protein Lymphoma 2 inhibitor; X- linked inhibitor of apoptosis protein inhibitor clofarabine Acute DNA polymerase lymphoblastic inhibitor; leukemia; Diffuse Ribonucleotide large B-cell reductase inhibitor lymphoma; Histiocytosis; Myelodysplastic syndrome; Non- Hodgkin lymphoma galectin-3 inhibitor Multiple myeloma Galectin-3 inhibitor (multiple myeloma), Kiromic, LLC/Texas Tech University Health Sciences Center/Universita degli Studi di Milano KM-301 Non-Hodgkin Enhancer of zeste lymphoma homolog 2 inhibitor 490-PXN Bcl-6 protein inhibitor enzastaurin Diffuse large B- Protein kinase C cell lymphoma beta inhibitor mitoxantrone Acute Topoisomerase II myelogenous modulator leukemia; Breast tumor; Cancer; Hormone refractory prostate cancer; Liver tumor; Multiple sclerosis; Non-Hodgkin lymphoma CB-5083 Multiple AAA ATPase myeloma; Solid inhibitor; tumor Transitional endoplasmic ATPase inhibitor LCL-161 Breast tumor; SMAC protein Leukemia; modulator; X- Multiple linked inhibitor of myeloma; Solid apoptosis protein tumor inhibitor trifarotene Acne vulgaris; Retinoic acid Cutaneous T-cell receptor gamma lymphoma; agonist Ichthyosis AMG-224 Multiple myeloma OXS-4235 Multiple Sequestosome 1 myeloma; Pagets inhibitor bone disease dovitinib CSF-1 antogonist; FGF1 receptor antagonist; FGF2 receptor antagonist; FGF3 receptor antagonist; Flt3 tyrosine kinase inhibitor; Kit tyrosine kinase inhibitor; PDGF receptor antagonist; Ret tyrosine kinase receptor inhibitor; SL cytokine ligand inhibitor; TrkA receptor antagonist; VEGF- 1 receptor antagonist; VEGF- 2 receptor antagonist; VEGF- 3 receptor antagonist danusertib Chronic Abl tyrosine myelocytic kinase inhibitor; leukemia; Solid Aurora protein tumor kinase inhibitor; FGF1 receptor antagonist; Ret tyrosine kinase receptor inhibitor; TrkA receptor antagonist CEP-8983 Advanced solid Poly ADP ribose tumor; Mantle cell polymerase 1 lymphoma; Non- inhibitor; Poly ADP small-cell lung ribose polymerase cancer; Solid 2 inhibitor tumor evofosfamide Astrocytoma; Topoisomerase II Biliary cancer; inhibitor Multiple myeloma; Pancreas tumor; Soft tissue sarcoma; Solid tumor bromocriptine, Galactorrhea; Dopamine D2 Novartis Parkinsons receptor agonist disease apilimod mesylate Non-Hodgkin IL-12 antagonist; (capsule, B-cell non- lymphoma IL-23 antagonist; Hodgkins PIKFYVE gene lymphoma), Lam inhibitor Therapeutics VRx-3996 Cancer; Multiple Histone myeloma deacetylase-1 inhibitor; Histone deacetylase-2 inhibitor; Histone deacetylase-3 inhibitor mocetinostat Acute Caspase-3 dihydrobromide myelogenous stimulator; leukemia; B-cell Caspase-7 lymphoma; stimulator; Histone Cancer; Chronic deacetylase-1 lymphocytic inhibitor; Histone leukemia; deacetylase-11 Hodgkins inhibitor; Histone disease; deacetylase-2 Leukemia; Non- inhibitor; Histone small-cell lung deacetylase-3 cancer; Pancreas inhibitor; Histone tumor; Solid deacetylase-4 tumor; inhibitor Transitional cell carcinoma TG-02 Chronic Brachyury protein lymphocytic inhibitor; Cyclin- leukemia; dependent kinase- Hematological 1 inhibitor; Cyclin- neoplasm; dependent kinase- Hepatocellular 2 inhibitor; Cyclin- carcinoma; dependent kinase- Multiple 5 inhibitor; Cyclin- myeloma; Solid dependent kinase- tumor 7 inhibitor; Cyclin- dependent kinase- 9 inhibitor; cytochrome P450 reductase inhibitor; Extracellular signal related kinase-5 inhibitor; Flt3 tyrosine kinase inhibitor; Jak2 tyrosine kinase inhibitor; Mcl-1 differentiation protein inhibitor; RNA polymerase II modulator; STAT5A gene modulator; p38 MAP kinase inhibitor VGC-001 T-cell lymphoma histone lysine Multiple myeloma Histone lysine methyltransferase methyltransferase NSD2 inhibitors NSD2 inhibitor (cancer), Inventiva IRAK-4 modulators IRAK-4 protein (inflammation), kinase modulator Aurigene CB-988 B-cell lymphoma Btk tyrosine kinase inhibitor DCDS-0780A Non-Hodgkin lymphoma dexamethasone Hormone Glucocorticoid (liposome refractory agonist; formulation, prostate cancer; Phospholipase A2 castration resistant Multiple myeloma inhibitor prostate carcinoma/multiple myeloma), Enceladus TRC-694 Hematological Nuclear factor neoplasm; kappa B inducing Multiple myeloma kinase inhibitor BCN-004 Non-Hodgkin Phosphoinositide lymphome 3-kinase inhibitor ixabepilone Breast tumor; Tubulin modulator Fallopian tube cancer; Metastatic breast cancer; Ovary tumor; Peritoneal tumor TC-11 Multiplet myeloma CPI-1205 Lymophoma Enhancer of zeste homolog 2 inhibitor NMS-E194 Multiple myeloma Proline rich receptor like kinase, PERK inhibitor minocycline Acinetobacter hydrochloride infection; (intravenous, Actinomyces bacterial infections), israelli infection; Rempex Bacillus anthracis Pharmaceuticals infection; Bacterial infection; Bartonella bacilliformis infection; Bartonellaceae infection; Borrelia recurrentis infection; Brucella infection; Campylobacter fetus infection; Cervix infection; Chlamydia trachomatis infection; Clostridium infection; Complicated skin and skin structure infection; Enterobacter aerogenes infection; Escherichia coli infection; Francisella tularensis infection; Fusobacterium infection; Granuloma; Haemophilus influenzae infection; Klebsiella granulomatis infection; Klebsiella infection; Listeria monocytogenes infection; Lymphogranulom a venereum; Meningitis; Mycoplasma pneumoniae infection; Neisseria meningitidis infection; Q fever; Respiratory tract infection; Rickettsia infection; Rocky mountain spotted fever; Scrub typhus; Shigella infection; Staphylococcus aureus infection; Streptococccus pneumoniae infection; Trachoma; Treponema pallidum infection; Ureaplasma urealyticum infection; Urethritis; Urinary tract infection; Vibrio cholerae infection; Yersinia pestis infection eltanexor Multiple myeloma Exportin 1 inhibitor EZH2 inhibitors (diffuse large B-cell lymphoma), Pfizer Diffuse large B-cell lymphoma Enhancer of zeste homolog 2 inhibitor

PIM-447 Acute PIM protein kinase myelogenous inhibitor; PIM-1 leukemia; protein kinase Multiple inhibitor; PIM-2 myeloma; protein kinase Myelodys- plastic inhibitor; PIM-3 syndrome; protein kinase Myelofibrosis inhibitor romidepsin (topical, Histone cancer), Gloucester deacetylase Pharmaceuticals inhibitor belinostat (oral, Cancer Histone cancer), Onxeo deacetylase inhibitor navitoclax Apoptosis regulator Bcl w inhibitor; Bcl-2 protein inhibitor; Bcl-xL Bcl-2 associated death promotor inhibitor barasertib Diffuse large Aurora protein B-cell kinase 1 inhibitor; lymphoma Aurora protein kinase 2 inhibitor SCM-02-138 Diffuse large MALT protein 1 B-cell inhibitor AZD-1208 lymphoma PIM protein kinase inhibitor CC-95821 Muleiple myeloma Protein cereblon modulator; Ubiquitin ligase modulator BET PROTAC Burkitts lymphoma; Cancer Bromodomain containing protein 4 inhibitor; C-myc binding protein inhibitor; E3 ubiquitin protein ligase CBL modulator; VHL gene modulator

cyclophosphamide Lymphoma monohydrate AMG-176 Multiple myeloma Mcl-1 differentiation protein inhibitor deubiquitinating Diffuse large B- Unspecified enzyme inhibitor (B- cell lymphoma enzyme inhibitor Cell lymphoma), University of Leicester veliparib Breast tumor; PARP inhibitor; Cancer; Poly ADP ribose Colorectal tumor; polymerase 1 Fallopian tube inhibitor; Poly ADP cancer; ribose polymerase Glioblastoma; 2 inhibitor Glioma; Gliosarcoma; Liver disease; Lymphoma; Metastasis; Metastatic breast cancer; Metastatic colorectal cancer; Metastatic head and neck cancer; Metastatic non small cell lung cancer; Metastatic pancrease cancer; Metastatic rectal cancer; Multiple myeloma; Neuroendocrine tumor; Ovary tumor; Peritoneal tumor; Prostate tumor; Renal disease; Small- cell lung cancer; Solid tumor; Stage IV melanoma RP-323 Acute Protein kinase C myelogenous stimulator leukemia; Hodgkins disease; Myelodysplastic syndrome plerixafor Bone marrow CXCR4 transplantation; chemokine Chronic antagonist; lymphocytic Neuroplastin leukemia; inhibitor Diabetic foor ulcer; Glioma; Neutropenia; Non-Hodgkin lymphoma; Sickle cell anemia melphalan AL amyloidosis; (intravenous/Captisol, Multiple myeloma multiple myeloma), Spectrum/CASI Pharmaceuticals fotemustine Melanoma; Uveal melanoma amoxicillin + Abdominal Beta lactamase clavulanate abscess; Acute inhibitor potassium GSK bronchitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bone and joint infection; Bronchitis; Cellulitis; Cystitis; Enterobacter infection; Escherichia coli infection; Female genital tract infection; Haemophilus influenzae infection; Haemophilus parainfluenzae infection; infectious disease; Klebsiella infection; Klebsiella pneumoniae infection; Laryngitis; Lower respiratory tract infection; Lymphangitis; Mastoiditis; Moraxella catarrhalis infection; Neisseria gonorrhoeae infection; Osteomyelitis; Otitis media; Pelvic inflammatory disease; Pharyngitis; Prophylaxis; Pyelonephritis; Sinusitits; Staphylococcus aureus infection; Tonsillitis belinostat (iv, Colorectal tumor; Histone cancer), Hepatocellular deacetylase Onxeo/Spectrum carcinoma; Non- inhibitor small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Solid tumor GSK-2126458 Idiopathic Phosphoinositide pulmonary 3-kinase inhibitor; fibrosis; mTOR complex 1 Lymphoma; inhibitor; mTOR Metastatic complex 2 inhibitor prostate cancer; Solid tumor picibanil Carcinoma; Cystic hygroma; Ranula anti-wolbachia Elephantiasis; therapy Filariasis; (onchocerciasis/lym- Onchocerciasis phatic filariasis), LSTM melphalan Cancer; Multiple Caspase-3 flufenamide myeloma; Ovary stimulator; hydrochloride tumor Peptidase modulator quisinostat Cutaneous T-cell Androgen receptor lymphoma; antagonist; Fallopian tube Histone H3 cancer; modulator; Metastatic ovary Histone cancer; Multiple deacetylase-1 myeloma; inhibitor; Histone Peritoneal tumor; deacetylase-2 Solid tumor inhibitor; Prostate specific antigen inhibitor Decuprate Motor neurone Superoxide disease; Wilson dismutase inhibitor disease next-generation BET bromodomain inhibitors (multiple myeloma), Dana- Farber Cancer Institute Multiple myeloma Bromodomain containing protein inhibitor

komaroviquinone Multiple myeloma derivatives (cancer), Keio University AZ-1495 Central nervous IRAK-1 protein system tumor; kinase inhibitor; Lymphoma IRAK-2 protein kinase inhibitor TAS-4464 Cancer; Amyloid protein Lymphoma; binding protein-1 Multiple myeloma inhibitor FF-10502-01 Lymphoma; Solid tumor doxorubicin Cancer; Kaposis DNA polymerase (liposomal, sarcoma; inhibitor; STEALTH), Alza Metastatic breast Topoisomerase II cancer; Multiple inhibitor myeloma; Ovary tumor; T-cell lymphoma SGX-301 Cutaneous T-cell lymphoma; Psoriasis pixantrone Breast tumor; DNA gyrase Lymphoma; inhibitor Metastasis; Non- Hodgkin lymphoma; Solid tumor tosedostat Acute Aminopeptidase myelogenous inhibitor; leukemia; Leukotriene A4 Myelodysplastic hydrolase inhibitor syndrome eprodisate Sarcoidosis Amyloid protein deposition inhibitor CC-90011 Advanced solid Lysine specific tumor; Non- histone Hodgkin demethylase 1 lymphoma; Solid inhibitor tumor DS-3201b Acute Enhancer of zeste lymphoblastic homolog 2 leukemia; Acute inhibitor myelogenous leukemia; Adult T-cell lymphoma; Non-Hodgkin lymphoma citarinostat Advanced solid Histone tumor; Mantle cell deacetylase-6 lymphoma; inhibitor Melanoma; Multiple myeloma ubenimex Acute Aminopeptidase myelogenous inhibitor; leukemia; Leukotriene A4 Carcinoma; hydrolase Lymphedema; inhibitor; Pulmonary artery Leukotriene BLT hypertension receptor antagonist RGX-104 Glioblastoma; Liver X receptor Lymphoma; agonist Melanoma; Solid tumor TAK-659 Acute Flt3 tyrosine myelogenous kinase inhibitor; leukemia; Syk tyrosine Chronic kinase inhibitor lymphocytic leukemia; Diffuse large B-cell lymphoma; Lymphoma; Solid tumor RG-6146 Acute Bromodomain myelogenous containing protein leukemia; inhibitor Multiple myeloma; Myelodysplastic syndrome; Solid tumor dezapelisib B-cell lymphoma; Phosphoinositide- Hodgkins disease 3 kinase delta inhibitor DS-3032 Advanced solid E3 ubiquitin tumor; Cancer; protein ligase hematological MDM2 inhibitor neoplasm; Liposarcoma; Lymphoma; Multiple myeloma; Soft tissue sarcoma valproic acid + Diffuse large B- Glucocorticoid prednisone (oral, cell lymphoma agonist; Histone diffuse large B-cell deacetylase lymphoma), inhibitor Valcuria/ Respiratorius VLX-1570 Cancer; Multiple Proteasome myeloma inhibitor; Ubiquitin carboxyl hydrolase isozyme L5 inhibitor; Ubiquitin thioesterase-14 inhibitor CC-115 Chronic DNA dependent lymphocytic protein kinase leukemia; inhibitor; mTOR Glioblastoma; Non-Hodgkin lymphoma; Solid tumor vincristine sulfate (liposome injection, cancer), Shanghai Fudan-Zhangijang Bio- Pharmaceutical/ Shanghai Pharmaceuticals NS-018 Multiple Jak2 tyrosine myeloma; kinase inhibitor; Myelodysplastic Src tyrosine syndrome; kinase inhibitor Myelofibrosis naloxone (topical Mycosis Opioid receptor lotion, CTCL- fungoides; antagonist associated pruritus), Pruritus Elorac peldesine Purine nucleoside phosphorylase inhibitor atiprimod CS-2164 Cancer; Non- Aurora protein Hodgkin kinase 1 inhibitor; lymphoma; Ovary PDGF receptor tumor antagonist; VEGF- 1 receptor antagonist; VEGF- 2 receptor antagonist; VEGF- 3 receptor antagonist pexidartinib Glioblastoma; CSF-1 antagonist; Gliosarcoma; Fit3 tyrosine Metastatic breast kinase inhibitor; cancer; Kit tyrosine kinase Pigmented inhibitor; SL villonodular cytokine ligand synovitis; Solid inhibitor tumor; Stage III melanoma; Stage IV melanoma roneparstat Multiple myeloma Heparanase inhibitor volasertib Polo-like kinase 1 inhibitor resminostat Biliary tumor; Arginase-I Colorectal tumor; inhibitor; Histone Cutaneous T-cell deacetylase lymphoma; inhibitor; Histone Hepatocellular deacetylase-1 carcinoma; inhibitor; Histone Hodgkins deacetylase-2 disease; Non- inhibitor; Histone small-cell lung deacetylase-3 cancer; Pancreas inhibitor; Histone tumor; Solid deacetylase-6 tumor inhibitor miltefosine (topical, cutaneous T-cell lymphoma), ExperGen amrubicin Bladder tumor; DNA gyrase Metastatic breast inhibitor; cancer; Multiple Topoisomerase II myeloma; Non- inhibitor small-cell lung cancer; Small-cell lung cancer; Thymus neoplasm silmitasertib Cancer; Casein kinase II Cholangiocarcino- inhibitor ma; Multiple myeloma fenretinide Cutaneous T-cell FGF receptor (intravenous lymphoma; antagonist; VEGF emulsion, Leukemia; receptor lymphoma/solid Lymphoma; antagonist tumors/pediatric Neuroblastoma; neuroblastomas/ Peripheral T-cell pediatric leukemia), lymphoma; Solid CerRx tumor doxorubicin Metastatic breast DNA polymerase hydrochloride cancer; inhibitor; (liposomal, Metastatic ovary Topoisomerase II chromane-6 cancer; Multiple inhibitor antioxidant), myeloma Lipotec/GP Pharm Sarcoma; Soft tissue sarcoma firtecan pegol Breast tumor; Hypoxia inducible Cancer; factor-1 alpha Colorectal tumor; modulator; Solid tumor Topoisomerase I inhibitor ENMD-2076 Breast tumor; Aurora protein Hepatocellular kinase 1 inhibitor; carcinoma; Aurora protein Leukemia; kinase 2 inhibitor, Multiple FGF1 receptor myeloma; antagonist; FGF3 Ovarian clear cell receptor carcinoma; Ovary antagonist; Flt3 tumor; Soft tissue tyrosine kinase sarcoma; Solid inhibitor; Jak2 tumor tyrosine kinase inhibitor; VEGF-1 receptor antagonist; VEGF- 2 receptor antagonist; X- linked inhibitor of apoptosis protein inhibitor AT-9283 (iv, Abl tyrosine cancer), Astex kinase inhibitor; Aurora protein kinase 1 inhibitor; Aurora protein kinase 2 inhibitor; Bcr protein inhibitor; Flt3 tyrosine kinase inhibitor; Jak2 tyrosine kinase inhibitor forodesine (oral, Peripheral T-cell Purine nucleoside cancer), lymphoma phosphorylase BioCryst/ inhibitor Mundipharma minodronic acid Osteroporosis abexinostat Breast tumor; Histone Follicle center deacetylase lymphoma; inhibitor Hematological neoplasm; Lymphoma; Mantle cell lymphoma; Nasopharyngeal carcinoma; Non- Hodgkin lymphoma; Renal cell carcinoma; Sarcoma; Solid tumor darinaparsin (iv, Peripheral T-cell cancer), Solasia lymphoma Pharma cefcapene Abscess; Acute Penicillin binding bronchitis; protein inhibitor Bacterial eye infection; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides infection; Bartholinitis; Cervicitis; Cholangitis; Cholecystitis; Citrobacter infection; Cystitis; Dacryocystitis; Enterobacter infection; Escherichia coli infection; Haemophilus influenzae infection; Jaw disease; Klebsiella infection; Laryngitis; Lymphangitis; Mastitis; Moraxella catarrhalis infection; Morganella morganii infection; Neisseria gonorrhoeae infection; Otitis externa; Otitis media; Pelvic inflammatory disease; Peptostreptococcus infection; Pericoronitis; Periodontal disease; Pharyngitis; Prevotella infection; Propionibacterium acnes infection; Proteus infection; Providencia infection; Pyelonephritis; Respiratory disease; Serratia infection; Sinusitis; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Tonsillitis; Urethritis; Uterus infection tasquinimod Hepatocellular S100 calcium carcinoma; binding protein A9 Multiple myeloma modulator forodesine B-cell acute Purine nucleoside (intravenous, lymphoblastic phosphorylase cancer), BioCryst/ leukemia; inhibitor Mundipharma Chronic lymphocytic leukemia; Leukemia; T-cell lymphoma arsenic trioxide, CTI Acute BioPharma Corp myelogenous leukemia; Acute promyelocytic leukemia; Bladder tumor; Brain tumor; Chronic myelocytic leukemia; Chronic myelomonocytic leukemia; Esophagus tumor; Glioma; Hodgkins disease; Lymphoid leukemia; Lymphoma; Melanoma; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Prostate tumor; Renal cell carcinoma; Uterine cervix tumor sapacitabine Acute DNA polymerase myelogenous inhibitor Leukemia; B-cell lymphoma; Chronic lymphocytic leukemia; Myelodysplastic syndrome; Non- small-cell lung cancer; Ovary tumor; Solid tumor RO-6870810 Multiple myeloma Bromodomain containing protein inhibitor nelfinavir (multiple Multiple myeloma myeloma), Swiss Group for Clinical Cancer Research para- Adenoid tumor; toluenesulfonamide Cancer (adenoid cystic carcinoma), PTS International MK-1454 Advanced solid Stimulator of tumor; interferon genes Lymphoma protein stimulator vitalethine resiquimod (topical Cutaneous T-cell IL2 gene gel, cutaneous T cell lymphoma stimulator; TLR-7 lymphoma) agonist; TLR-8 Galderma/University agonist of Pennsylvania sirolimus (inhaled, Lymphangioleio- mTOR inhibitor lymphangioleiomyo- myomatosis; matosis/pulmonary Pulmonary artery artery hypertension), hypertension LAM Therapeutics M-2951 Diffuse large B- Btk tyrosine cell lymphoma; kinase inhibitor Multiple sclerosis; Rheumatoid arthritis; Systemic lupus erythematosus RG-7845 Autoimmune Btk tyrosine disease; kinase inhibitor Rheumatoid arthritis; Systemic lupus erythematosus; Urticaria ME-401 Chronic Phosphoinositide- lymphocytic 3 kinase delta leukemia; Follicle inhibitor center lymphoma; Hematological neoplasm AR-42 Acoustic Histone neuroma; deacetylase Hematological inhibitor neoplasm; Meningioma; Multiple myeloma; Neurofibromatosis type II; Solid tumor SP-2-59 Multiple myeloma Histone deacetylase-6 inhibitor bimiralisib Cancer; Central Phosphoinositide nervous system 3-kinase inhibitor; tumor; Diffuse mTOR complex 1 large B-cell inhibitor; mTOR lymphoma; complex 2 inhibitor Glioblastoma; Lymphoma; Metastatic breast cancer; Non- Hodgkin lymphoma; Solid tumor taselisib Breast tumor; Phosphoinositide Metastatic breast 3-kinase inhibitor cancer; Non- Hodgkin lymphoma; Solid tumor MBC-11 Bone metastases; multiple myeloma; Prostate tumor DaunoXome Acute myelogenous leukemia; Kaposis sarcoma eFT-508 Lymphoma; MNK1 protein Metastatic kinase inhibitor; colorectal cancer; MNK2 protein Solid tumor kinase inhibitor sapanisertib Anaplastic thyroid mTOR complex 1 cancer; Breast inhibitor; mTOR tumor; complex 2 inhibitor Endometrioid carcinoma; Hepatocellular carcinoma; Lymphoma; Macroglobulinemia; Merkel cell carcinoma; Metastatic renal cancer; Multiple myeloma; Prostate tumor; Renal tumor; Solid tumor; Transitional cell carcinoma zoledronic acid Bone metastases; Bone resorption; Breast tumor; Hypercalcemia; Male osteoporosis; Mesothelioma; Metastasis; Multiple myeloma; Osteoarthritis; Osteogenesis imperfecta; Osteoporosis; Pagets bone disease; Postmenopausal osteoporosis mechlorethamine Cutaneous T-cell hydrochloride lymphoma; (topical gel, Mycosis CTCL/mycosis fungoides fungoides), Yaupon irinotecan Brain tumor; Topoisomerase I Breast tumor; inhibitor Colorectal tumor; Lung tumor; Metastatic colorectal cancer; Metastatic pancreas cancer; Non-Hodgkin lymphoma; Ovary tumor; Solid tumor; Squamous cell carcinoma; Stomach tumor; Uterus tumor clarithromycin Abscess; Acute bronchitis; Acute sinusitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bordetella pertussis infection; Campylobacter infection; Cervicitis; Chlamydia infection; Chlamydia pneumoniae infection; Chronic bronchitis; Enterocolitis; Haemophilus influenzae infection; Haemophilus parainfluenzae infection; Helicobacter pylori infection; Laryngitis; Legionella infection; Lymphadenitis; Lymphangitis; Moraxella catarrhalis infection; Mycobacterium infection; Mycoplasma infection; Otitis media; Peptostreptococcus infection; Pericoronitis; Periodontitis; Pharyngitis; Prophylaxis; Sinusitis; Staphylococcus aureus infection; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Tonsillitis; Urethritis bexarotene (oral Cutaneous T-cell Insulin sensitizer; formulation), Eisai lymphoma Retinoid X receptor modulator bexarotene (gel Cutaneous T-cell Retinoid X formulation), lymphoma receptor Eisai/Minophagen modulator OXS-3550 B-cell lymphoma acalabrutinib B-cell lymphoma; Btk tyrosine Chronic kinase inhibitor lymphocytic leukemia; Glioblastoma; Macroglobulinemia; Mantle cell lymphoma; Metastatic bladder cancer; Metastatic head and neck cancer; Metastatic pancreas cancer; Non-small-cell lung cancer; Ovary tumor; Rheumatoid arthritis RRx-001 Cholangiocarcino- DNA ma; Colorectal methyltransferase tumor; Multiple inhibitor; Epigen myeloma; modulator Neuroendocrine tumor; Non- small-cell lung cancer; Ovary tumor; Small-cell lung cancer topotecan Lung tumor; Topoisomerase I Ovary tumor; inhibitor Small-cell lung cancer; Solid tumor; Uterine cervix tumor ricolinostat Cancer; Histone Cholangiocarcino- deacetylase-1 ma; Cilia disease; inhibitor; Histone Diabetic deacetylase-2 neuropathy; inhibitor; Histone Lymphoma; deacetylase-6 Multiple inhibitor myeloma; Neuropathy; Polycystic kidney disease mitoxantrone Lymphoma; Topoisomerase II hydrochloride Metastatic breast modulator (liposome, cancer; Non- lymphoma), CSPC Hodgkin Zhongqi lymphoma; Solid Pharmaceutical tumor Technology (Shijiazhuang) Co Ltd bendamustine Chronic PARP modulator hydrochloride lymphocytic (ready-to-dilute, iv, leukemia; Non- chronic lymphocytic Hodgkin leukemia/non- lymphoma Hodgkin's lymphoma), Eagle Pharmaceuticals idasanutlin Acute Mdm2 p53-binding myelogenous protein inhibitor leukemia; Hematological neoplasm; Non- Hodgkin lymphoma; Polycythemia vera; Solid tumor; Thrombocythemia Poly-ICLC Cancer; Glioma; Interferon agonist; Metastatic colon TLR-3 agonist cancer; Metastatic pancreas cancer; Non-Hodgkin lymphoma; Solid tumor; Stroke; Viral infection vorinostat (oral), Acute Histone Merck & Co myelogenous deacetylase leukemia; B-cell inhibitor; Histone lymphoma; deacetylase-1 Breast tumor; inhibitor; Histone Chronic deacetylase-2 lymphocytic inhibitor; Histone leukemia; deacetylase-3 Colorectal tumor; inhibitor; Histone Cutaneous T-cell deacetylase-6 lymphoma; inhibitor Diffuse large B- cell lymphoma; Follicle center lymphoma; HIV infection; Leukemia; Lymphoma; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastasis; Metastatic non small cell lung cancer; Metastatic renal cancer; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Prostate tumor; Renal tumor; Sarcoma; Small- cell lung cancer; Solid tumor pentostatin Chronic Adenosine lymphocytic deaminase leukemia; Hairy inhibitor cell leukemia retinoic acid Adenoid tumor MYB gene agonists (adenoid inhibitor; Retinoic cystic carcinoma), acid receptor Boston Children's agonist Hospital KA-2237 B-cell lymphoma; Phosphoinositide- Inflammatory 3 kinase beta disease; Solid inhibitor; tumor Phosphoinositide- 3 kinase delta inhibitor motolimod B-cell lymphoma; TLR-8 agonist Fallopian tube cancer; Head and neck tumor; Ovary tumor; Peritoneal tumor entinostat Acute Histone myelogenous deacetylase leukemia; Breast inhibitor tumor; Colorectal tumor; Lymphoma; Melanoma; Metastatic breast cancer; Metastatic non small cell lung cancer; Metastatic renal cancer; Myelodysplastic syndrome; Non- small-cell lung cancer; Ovary tumor; Uveal melanoma CLR-131 Glioma; Head and neck tumor; Hematological neoplasm; Multiple myeloma; Solid tumor; Uterus tumor afuresertib AKT protein kinase inhibitor SNX-5422 (oral, Cancer, Chronic Hsp 90 inhibitor cancer), Esanex lymphocytic leukemia; Hematological neoplasm; Non- Hodgkin lymphoma; Solid tumor AT-7519 Chronic Cyclin-dependent lymphocytic kinase-1 inhibitor; leukemia; Cyclin-dependent Hematological kinase-2 inhibitor; neoplasm; Mantle Cyclin-dependent cell lymphoma; kinase-3 inhibitor; Multiple Cyclin-dependent myeloma; Non- kinase-4 inhibitor; Hodgkin Cyclin-dependent lymphoma; Solid kinase-5 inhibitor; tumor Cyclin-dependent kinase-6 inhibitor; Cyclin-dependent kinase-7 inhibitor; Cyclin-dependent kinase-9 inhibitor; Glycogen synthase kinase-3 beta inhibitor; RNA polymerase II inhibitor CKD-581 (iv, Lymphoma; Caspase-3 cancer), Chong Multiple myeloma stimulator; Kun Dang Caspase-7 stimulator; Caspase-9 stimulator; Histone deacetylase inhibitor pralatrexate B-cell lymphoma; DHFR inhibitor; Bladder tumor; Folate antagonist; Breast tumor; Folate transporter Cutaneous T-cell 1-modulator lymphoma; Esophagus tumor; Fallopian tube cancer; Head and neck tumor; Multiple myeloma; Non- small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Peritoneal tumor; Stomach tumor retaspimycin (iv, Flt3 tyrosine cancer), Infinity kinase modulator; Hsp 90 inhibitor; Kit tyrosine kinase modulator RP-4010 Non-Hodgkin Ca2+ release lymphoma activated Ca2+ channel inhibitor opaganib Cholangiocarcino- Dihydroceramide ma; Diffuse large delta 4 desaturase B-cell lymphoma; inhibitor; Hepatocellular Sphingosine carcinoma; kinase 2 inhibitor Multiple myeloma; Prostate tumor; Radiation sickness thalidomide, TTY Erythema TNF alpha ligand Biopharm nodosum leprae; inhibitor Hepatocellular carcinoma; Multiple myeloma; Myelodysplastic syndrome mometasone Allergic rhinitis; furoate (nasal), Nasal polyps; Merck & Co Perennial allergic rhinitis; Seasonal allergic rhinitis GSK-3326595 Non-Hodgkin Protein arginine N- lymphoma methyltransferase 5 inhibitor tirabrutinib B-cell lymphoma; Btk tyrosine hydrochloride Chronic kinase inhibitor lymphocytic leukemia; Non- Hodgkin lymphoma; Rheumatoid arthritis; Sjoegrens syndrome; Systemic lupus erythematosus entospletinib Acute Syk tyrosine myelogenous kinase inhibitor leukemia; B-cell acute lymphoblastic leukemia; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Macroglobulinemi- a; Mantle cell lymphoma; Non- Hodgkin lymphoma alpelisib Metastatic breast Phosphoinositide- cancer; Multiple 3 kinase alpha myeloma inhibitor vinorelbine Breast tumor; Mesothelioma; Metastatic breast cancer; Metastatic non small cell lung cancer; Multiple myeloma; Non- small-cell lung cancer CWP-291 Acute Beta-catenin myelogenous inhibitor leukemia; Cancer; Chronic myelomonocytic leukemia; Multiple myeloma; Myelodysplastic syndrome vemurafenib Colorectal tumor; Raf B protein Hairy cell kinase inhibitor leukemia; Histiocytosis; Multiple myeloma; Non- small-cell lung cancer; Solid tumor; Stage IV melanoma saracatinib Alcoholism; Abl tyrosine Alzheimers kinase inhibitor; disease; Fyn tyrosine Lymphangioleio- kinase inhibitor; myomatosis; Src tyrosine Ostealgia; Otitis kinase inhibitor media; Psychiatric disorder temsirolimus Acute FK506 binding lymphoblastic protein-12 leukemia; modulator; mTOR Adrenal cortical inhibitor carcinoma; Angiosarcoma; Bladder cancer; Blastoma; Central nervous system tumor; Endometrioid carcinoma; Glioma; Head and neck tumor; Hemangiopericy- toma; Hemangiosarco- ma; Hepatocellular carcinoma; Hodgkins disease; Lymphoblastic leukemia; Mantle cell lymphoma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Ovarian clear cell carcinoma; Paraganglioma; Peripheral T-cell lymphoma; Pheochromocyto- ma; Renal cell carcinoma; Rhabdomyosarco- ma; Thymus neoplasm; Thyroid tumor everolimus Acute mTOR complex 1 lymphoblastic inhibitor; mTOR leukemia; inhibitor Advanced solid tumor; Angiomyolipoma; Astrocytoma; Bladder cancer; Breast tumor; Colorectal tumor; Cutaneous T-cell lymphoma; Diffuse large B- cell lymphoma; Endometrioid carcinoma; Epilepsy; Esophagus tumor; Glioma; Head and neck tumor; Heart transplant rejection; Kidney transplant rejection; Liver transplant rejection; Lung transplant rejection; Macroglobulinemi- a; Medullary thyroid cancer; Metastatic breast cancer; Metastatic renal cancer; Multiple hamartoma sydrome; Neuroendocrine tumor; Neurofibromatosis type I; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Pancreatic endocrine tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Thyroid tumor; Transplant rejection; Uveal melanoma sunitinib Adrenal cortical CSF-1 antagonist; carcinoma; Flt3 tyrosine Anaplastic kinase inhibitor; astrocytoma; Kit tyrosine kinase Angiosarcoma; inhibitor; PDGF Blastoma; receptor alpha Central nervous antagonist; PDGF system tumor; receptor beta Chondrosarcoma; antagonist; RET Endometrioid tyrosine kinase carcinoma; receptor family Gastrointestinal inhibitor; VEGF-1 stromal tumor; receptor Genitourinary antagonist; VEGF- tract tumor; 2 receptor Glioblastoma; antagonist; VEGF- Glioma; 3 receptor Hemangiopericytoma; antagonist Hemangiosarcoma; Hepatocellular carcinoma; Hippel Lindau syndrome; Mesothelioma; Neuroendocrine tumor; Neurofibromatosis type I; Ovarian clear cell carcinoma; Ovary tumor; Pancreatic endocrine tumor; Paraganglioma; Pheochromocyto- ma; Pulmonary hypertension; Renal cell carcinoma; Stage IV melanoma; Testis tumor; Thymus neoplasm; Thyroid tumor; Transitional cell carcinoma; Uterine cervix tumor G-100 Follicle center TLR-4 agonist lymphoma; Merkel cell cardinoma; Soft tissue sarcoma CKI-27 Multiple BRAF gene myeloma; Solid inhibitor; MEK-1 tumor protein kinase inhibitor; Raf 1 protein kinase inhibitor; Raf B protein kinase inhibitor buparlisib Diffuse large B- Phosphoinositide cell lymphoma; 3-kinase inhibitor Follicle center lymphoma; Hematological neoplasm; Mantle cell lymphoma; Myelofibrosis MAK-683 Diffuse large B- Polycomb protein cell lymphoma; EED inhbitor Nasopharyngeal carcinoma givinostat Acute Bradykinin myelogenous receptor leukemia; Becker modulator; muscular Histone dystrophy; deacetylase Crohns disease; inhibitor; P2X7 Duchenne purinoceptor dystrophy; agonist; Hodgkins Unspecified disease; Juvenile cytokine receptor rheumatoid antagonist arthritis; Multiple myeloma; Myeloproliferative disorder; Polycythemia vera ONC-201, Acute AKT protein Oncoceutics lymphoblastic kinase inhibitor; leukemia; Acute Dopamine D2 myelogenous receptor leukemia; Breast antagonist; TRAIL tumor; Diffuse receptor agonist; large B-cell Unspecified lymphoma; GPCR antagonist Endometrioid carcinoma; Glioblastoma; Mantle cell lymphoma; Metastatic breast cancer; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Solid tumor crenigacestat Solid tumor; T- Gamma-secretase cell acute inhibitor; Notch lymphoblastic antagonist; Notch leukemia; T-cell receptor lymphoma modulator vistusertib Advanced solid mTOR complex 1 tumor; Diffuse inhibitor; mTOR large B-cell complex 2 inhibitor lymphoma; Meningioma; Metastatic breast cancer; Non- small-cell lung cancer; Prostate tumor; Small-cell lung cancer; Stomach tumor pacritinib Acute CSF-1 antagonist; myelogenous Cytochrome P450 Leukemia; reductase Chronic inhibitor; Flt3 lymphocytic tyrosine kinase leukemia; Graft inhibitor; IRAK-1 versus host protein kinase disease; inhibitor; Jak2 Myelofibrosis; tyrosine kinase Thrombocytopenia inhibitor vismodegib B-cell lymphoma; Hedgehog protein Basal cell inhibitor; carcinoma; Basal Smoothened cell nevus receptor syndrome; antagonist Chronic lymphocytic leukemia; Head and neck tumor; Idiopathic pulmonary fibrosis; Meningioma; Metastatic prostate cancer; Myelodysplastic syndrome; Myelofibrosis; Odontogenic tumor; Pancreatic ductal adenocarcinoma; Sarcoma; Stomach tumor gemcitabine Biliary cancer; Bladder tumor; Breast tumor; Cancer; Carcinoma; Hepatobiliary system tumor; Lymphoma; Metastatic breast cancer; Metastatic non small cell lung cancer; Metastatic pancrease cancer; Non-small-cell lung cancer; Ovary tumor; Pancrease tumor; Renal cell carcinoma SHR-1459 B-cell lymphoma; Rheumatoid arthritis palbociclib Acute Cyclin-dependent lymphoblastic kinase-4 inhibitor; leukemia; Acute Cyclin-dependent myelogenous kinase-6 inhibitor; leukemia; Breast Retinoblastoma tumor; associated protein Carcinoma; Head modulator and neck tumor; Hormone refractory prostate cancer; Mantle cell lymphoma; Metastatic breast cancer; Metastatic prostate cancer; Multiple myeloma; Non- small-cell lung cancer; Pancreatic ductal adenocarcinoma; Renal failure; Solid tumor; Squamous cell carcinoma; Stage IV melanoma BCL-201 Acute Bcl-2 protein myelogenous inhibitor leukemia; Chronic lymphocytic leukemia; Follicle center lymphoma; Mantle cell lymphoma; Myelodysplastic syndrome; Non- Hodgkin lymphoma dasatinib Acute Abl tyrosine lymphoblastic kinase inhibitor; leukemia; Acute Bcr protein myelogenous inhibitor; EPH leukemia; Breast family tyrosine tumor; kinase inhibitor; Cholangiocarcino- Fyn tyrosine ma; Chronic kinase inhibitor; myelocytic Kit tyrosine kinase leukemia; inhibitor; Lck Colorectal tumor; tyrosine kinase Glioblastoma; inhibitor; PDGF-B Head and neck ligand inhibitor; tumor; Src tyrosine Metastasis; kinase inhibitor; Sarcoma; Solid Yes tyrosine tumor kinase inhibitor idelalisib AL amyloidosis; Phosphoinositide- Chronic 3 kinase delta lymphocytic inhibitor leukemia; Follicle center lymphoma; Macroglobulinemi- a; Mantle cell lymphoma; Myelofibrosis; Non-Hodgkin lymphoma; Pancreatic ductal adenocarcinoma doxorubicin Breast tumor; DNA polymerase (liposome Non-Hodgkin inhibitor; formulation), lymphoma; Ovary Topoisomerase II Cephalon tumor inhibitor cytarabine- Acute asparagine lymphoblastic conjugate leukemia; Acute (leukemia), myelogenous BioSight leukemia; Chronic myelocytic leukemia; Non- Hodgkin lymphoma panobinostat (oral), Advanced solid Cytochrome P450 Novartis tumor; Cancer; 2D6 inhibitor; Glioma; Graft Histone versus host deacetylase disease; HIV-1 inhibitor; Histone infection; deacetylase-1 Hormone inhibitor; Histone refractory deacetylase-2 prostate cancer; inhibitor; Histone Macroglobulinemi- deacetylase-3 a; Multiple inhibitor; Histone myeloma; deacetylase-6 Myelofibrosis; inhibitor; JAK2 Neuroendocrine gene inhibitor; tumor; Non- Orphan nuclear small-cell lung hormone receptor cancer; Sickle NR4A1 agonist cell anemia; Stage IV melanoma azacitidine Acute DNA myelogenous methyltransferase leukemia; inhibitor Chronic lymphocytic leukemia; Chronic myelocytic leukemia; Colorectal tumor; Follicle center lymphoma; Glioma; Hormone refractory prostate cancer; Marginal zone B- cell lymphoma; Metastatic breast cancer; Multiple myeloma; Myelodysplastic syndrome; Ovary tumor; Renal cell carcinoma ARQ-531 Chronic Btk tyrosine lymphocytic kinase inhibitor leukemia; Diffuse large B-cell lymphoma; Hematological neoplasm MOL-4249 Cutaneous T-cell STAT-3 inhibitor lymphoma; Psoriasis leukemia therapy, B-cell lymphoma; Btk tyrosine Centaurus Chronic kinase inhibitor Biopharma lymphocytic leukemia; Macroglobulinemia selinexor Acute Abl tyrosine myelogenous kinase inhibitor; leukemia; B-cell Bcr protein lymphoma; inhibitor; Cyclin- Cancer; Chronic dependent kinase lymphocytic inhibitor 1B leukemia; stimulator; Cutaneous T-cell Exportin 1 inhibitor lymphoma; Diffuse large B- cell lymphoma; Endometrioid carcinoma; Female genital tract tumor; Gastrointestinal tumor; Glioblastoma; Hematological neoplasm; Hormone refractory prostate cancer; Liposarcoma; Lung tumor; Metastatic breast cancer; Multiple myeloma; Myelodysplastic syndrome; Neuroendocrine tumor; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Ovary tumor; Pancreas tumor; Peripheral T-cell lymphoma; Rectal tumor; Sarcoma; Small- cell lung cancer; Spina bifida; Squamous cell carcinoma; Systemic lupus erythematosus; Thymoma; Uterine cervis tumor; Viral infection TGR-1202 B-cell lymphoma; Phosphoinositide- Chronic 3 kinase delta lymphocytic inhibitor leukemia; Diffuse large B-cell lymphoma; Follicle center lymphoma; Hematological neoplasm; Hodgkins disease; Myelofibrosis; Non-Hodgkin lymphoma; Polycythemia vera; Solid tumor cerdulatinib Chronic JAK tyrosine lymphocytic kinase inhibitor; leukemia; Non- Syk tyrosine Hodgkin kinase inhibitor lymphoma; Rheumatoid arthritis duvelisib Chronic Phosphoinostide- lymphocytic 3 kinase delta leukemia; Follicle inhibitor; center Phosphoinositide- lymphoma; 3 kinase gamma Hematological inhibitor neoplasm; Lymphoma; Non- Hodgkin lymphoma; T-cell lymphoma avadomide Chronic Pleiotropic drug lymphocytic resistance leukemia; Diffuse transporter large B-cell modulator; Protein lymphoma; cereblon Hepatocellular modulator carcinoma; Multiple myeloma; Non- Hodgkin lymphoma; Solid tumor tucidinostat Acute Histone myelogenous deacetylase-1 leukemia; Breast inhibitor; Histone tumor; Cancer; deacetylase-10 Cutaneous T-cell inhibitor; Histone lymphoma; deacetylase-2 Diffuse large B- inhibitor; Histone cell lymphoma; deacetylase-3 Non-Hodgkin inhibitor lymphoma; Non- small-cell lung cancer; Peripheral T-cell lymphoma; Solid tumor fostamatinib Autoimmune Syk tyrosine disodium hemolytic kinase inhibitor anemia; IgA nephropathy; Immune thrombocytopenic purpura; Systemic lupus erythematosus celecoxib Ankylosing Cyclooxygenase 2 spondylitis; Back inhibitor pain; Breast tumor; Dysmenorrhea; Familial adenomatous polyposis; Osteoarthritis; Pain; Periarthritis; Rheumatoid arthritis; Tenosynovitis S-64315 Acute Mcl-1 myelogenous differentiation leukemia; Diffuse protein inhibitor large B-cell lymphoma; Multiple myeloma; Myelodysplastic syndrome itacitinib Advanced solid Jak1 tyrosine tumor; B-cell kinase inhibitor lymphoma; Diffuse large B- cell lymphoma; Graft versus host disease; Hodgkins disease; Myelofibrosis; Non-small-cell lung cancer; Pancrease tumor BGB-3111 B-cell lymphoma; Btk tyrosine Chronic kinase inhibitor lymphoctyic leukemia; Diffuse large B-cell lymphoma; Hematological neoplasm; Macroglobulinemi- a; Mantle cell lymphoma; Solid tumor encorafenib Advanced solid Raf B protein tumor; kinase inhibitor Melanoma; Metastatic colorectal cancer; Multiple myeloma; Non- small-cell lung cancer; Stage IV melanoma venetoclax Acute Bcl-2 protein myelogenous inhibitor leukemia; Cancer; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Follicle center lymphoma; Hematological neoplasm; Mantle cell lymphoma; Metastatic breast cancer; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Systemic lupus erythematosus copanlisib Advanced solid Phosphoinositide tumor; Breast 3-kinase inhibitor tumor; Cholangiocarcino- ma; Diffuse large B-cell lymphoma; Endometrioid carcinoma; Follicle center lymphoma; Marginal zone B- cell lymphoma; Non-Hodgkin lymphoma; Peripheral T-cell lymphoma; Splenic marginal zone lymphoma GMI-1271 Acute E-Selectin myelogenous antagonist leukemia; Deep vein thrombosis; Metastasis; Multiple myeloma; Myocardial infarction; Pancrease tumor; Solid tumor; Thromboembolism binimetinib Acute BRAF gene myelogenous inhibitor; MEK leukemia; protein kinase Adenocacinoma; inhibitor; MEK-1 Advanced solid protein kinase tumor; Biliary inhibitor; MEK-2 cancer; Cancer; protein kinase Chronic inhibitor; PERK myelocytic gene inhibitor leukemia; Colorectal tumor; Liver disease; Melanoma; Metastatic colorectal cancer; Multiple myeloma; Neurofibromatosis type I; Noonan syndrome; Prostate tumor; Stage IV melanoma; Uveal melanoma trametinib Acute MEK-1 protein myelogenous kinase inhibitor; leukemia; Biliary MEK-2 protein cancer; kinase inhibitor Colorectal tumor; Endometrioid carcinoma; Leukemia; Melanoma; Metastatic non small cell lung cancer; Metastatic rectal cancer; Non- small-cell lung cancer; Pancreas tumor; Solid tumor; Stage III melanoma; Stage IV melanoma; Thyroid tumor; Uterine cervix tumor ibrutinib Acute Btk tyrosine myelogenous kinase inhibitor leukemia; Allergic rhinitis; Autoimmune disease; B-cell acute lymphoblastic leukemia; B-cell lymphoma; Breast tumor; Carcinoid tumor; Chronic lymphocytic leukemia; Colorectal tumor; Diffuse large B- cell lymphoma; Follicle center lymphoma; Graft versus host disease; Hairy cell leukemia; Lymphoplasmacy- toid lymphoma; Macroglobulinemi- a; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastatic non small cell lung cancer; Metastatic renal cancer; Multiple myeloma; Neuroendocrine tumor; Non- Hodgkin lymphoma; Pancreas tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Systemic mastocytosis; T- cell lymphoma; Transitional cell carcinoma ruxolitinib (oral, Acute Jak1 tyrosine myeloproliferative lymphoblastic kinase inhibitor; disorders), leukemia; Acute Jak2 tyrosine Incyte/Novartis myelogenous kinase inhibitor leukemia; B-cell lymphoma; Breast disease; Cachexia; Chronic lymphocytic leukemia; Chronic myelocytic leukemia; Graft versus host disease; Head and neck tumor; Hodgkins disease; Leukemia; Metastatic breast cancer; Myelofibrosis; Polycythemia vera; Splenomegaly; T- cell lymphoma; Thalassemia major; Thrombocythemia cabozantinib S- Acute Axl tyrosine kinase malate myelogenous receptor inhibitor; leukemia; Flt3 tyrosine Advanced solid kinase inhibitor; tumor; Bladder Hepatocyte growth cancer; Bone factor antagonist; metastases; Kit tyrosine kinase Breast tumor; inhibitor; MET Cancer; tyrosine kinase Colorectal tumor; receptor family Endometrioid inhibitor; RET carcinoma; tyrosine kinase Gastrointestinal receptor family stromal tumor; inhibitor; Tek Glioblastoma; tyrosine kinase Hepatocellular receptor inhibitor; carcinoma; TrkB receptor Medullary thyroid antagonist; VEGF cancer; Merkel receptor cell carcinoma; antagonist; VEGF- Metastatic renal 1 receptor cancer; Multiple antagonist; VEGF- myeloma; 2 receptor Neuroendocrine antagonist; VEGF- tumor; Non- 3 receptor small-cell lung antagonist cancer; Ovary tumor; Pancreas tumor; Papillary thyroid tumor; Renal cell carcinoma; Soft tissue sarcoma bosutinib Acute Abl tyrosine lymphoblastic kinase inhibitor; leukemia; DNA gyrase Advanced solid inhibitor; Src tumor; Chronic tyrosine kinase myelocytic inhibitor leukemia; Dementia; Multiple myeloma; Non- Hodgkin lymphoma pomalidomide AL amyloidosis; Cancer; Multiple myeloma; Myelofibrosis; Scleroderma bortezomib Acute 26S proteasome proteasome lymphoblastic complex inhibitor; leukemia; Acute Proteasome myelogenous inhibitor leukemia; Breast tumor; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Head and neck tumor; Hormone refractory prostate cancer; Kidney transplant rejection; Macroglobulinemi- a; Mantle cell lymphoma; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Solid tumor; Squamous cell carcinoma; Stage IV melanoma MOL-4239, Cutaneous T-cell STAT-3 inhibitor Moleculin Biotech lymphoma; Psioriasis febuxostat Gout; Xanthine oxidase Hyperuricemia; inhibitor Tumor lysis syndrome milciclib Breast tumor; Cyclin dependent Hepatocellular kinase inhibitor; carcinoma; Liver Cyclin-dependent tumor; Thymus kinase-1 inhibitor; neoplasm Cyclin-dependent kinase-4 inhibitor; Cyclin-dependent kinase-5 inhibitor; Cyclin-dependent kinase-7 inhibitor alisertib Aurora protein kinase 2 inhibitor vinorelbine Cutaneous T-cell (intravenous/ lymphoma; Non- liposome Hodgkin encapsulated, lymphoma; cancer), Taiwan Rhabdomyosarco- Liposome ma; Soft tissue sarcoma pazopanib Bladder cancer; FGF1 receptor Merkel cell antagonist; FGF3 carcinoma; receptor Prostate tumor; antagonist; Itk Renal cell tyrosine kinase carcinoma; Soft inhibitor; Kit tissue sarcoma tyrosine kinase inhibitor; Lck tyrosine kinase inhibitor; Ltk tyrosine kinase receptor inhibitor; PDGF receptor alpha antagonist; PDGF receptor beta antagonist; Protein tyrosine kinase inhibitor; VEGF-1 receptor antagonist; VEGF- 2 receptor antagonist; VEGF- 3 receptor antagonist axitinib Advanced solid Bcr protein tumor; Carcinoid inhibitor; CD79 tumor; Chronic antagonist; CSF-1 myelocytic antagonist; PDGF leukemia; receptor Glioblastoma; antagonist; Protein Hepatocellular tyrosine kinase carcinoma; inhibitor; Tyrosine Melanoma; protein kinase Multiple ABL1 inhibitor; myeloma; VEGF receptor Nasopharyngeal antagonist; VEGF- carcinoma; Non- 1 receptor Hodgkin antagonist; VEGF- lymphoma; 2 receptor Prostate tumor; antagonist; VEGF- Renal cell 3 receptor carcinoma antagonist thalidomide, Multiple Celgene myeloma; Mycobacterium leprae infection imiquimod Basal cell TLR-7 agonist carcinoma; Condyloma; Keratosis; Molluscum contagiosum infection; Mycosis fungoides; Verruca vulgaris masitinib Alzheimers CSF-1 antagonist; disease; Asthma; FGF3 receptor Breast tumor; antagonist; Fyn Chronic tyrosine kinase obstructive inhibitor; Kit pulmonary tyrosine kinase disease; inhibitor; Lyn Gastrointestinal tyrosine kinase tumor; inhibitor; NK cell Glioblastoma; receptor Hormone modulator; PDGF refractory receptor prostate cancer; antagonist; Protein Ischemic stroke; tyrosine kinase Mastocytosis; inhibitor Melanoma; Metastatic breast cancer; Metastatic colorectal cancer; Metastatic head and neck cancer; Metastatic liver cancer; Metastatic non small cell lung cancer; Metastatic ovary cancer; Metastatic pancreas cancer; Metastatic stomach cancer; Motor neurone disease; Multiple myeloma; Multiple sclerosis; Pancreas tumor; Peripheral T-cell lymphoma; Progressive supranuclear palsy; Rheumatoid arthritis nintedanib Acute FGF receptor myelogenous antagonist; FGF1 leukemia; receptor Advanced solid antagonist; FGF2 tumor; Bladder receptor cancer; Breast antagonist; FGF3 tumor; receptor Endometrioid antagonist; PDGF carcinoma; receptor alpha Glioblastoma; antagonist; PDGF Hepatic receptor insufficiency; antagonist; PDGF Hepatocellular receptor beta carcinoma; antagonist; VEGF Hormone receptor refractory antagonist; VEGF- prostate cancer; 1 receptor Idiopathic antagonist; VEGF- pulmonary 2 receptor fibrosis; antagonist; VEGF- Inflammatory 3 receptor breast cancer; antagonist Interstitial lung disease; Lymphangioleio- myomatosis; Mesothelioma; Metastatic colorectal cancer; Metastatic non small cell lung cancer; Neuroendocrine tumor; Ovarian clear cell carcinoma; Ovary tumor; Renal cell carcinoma; Scleroderma; Soft tissue sarcoma; Stage IV melanoma; Thyroid tumor fluticasone Allergic rhinitis; propionate Asthma etoposide Acute Topoisomerase II phosphate myelogenous inhibitor leukemia; Choriocarcinoma; Germ cell and embryonic cancer; Hodgkins disease; Hormone refractory prostate cancer; Lung tumor; Non- hodgkin lymphoma; Small-cell lung cancer vandetanib Biliary cancer; EGFR family Brain tumor; tyrosine kinase Breast tumor; receptor inhibitor; Colorectal tumor; EPH family Glioblastoma; tyrosine kinase Medullary thyroid inhibitor; cancer; Epidermal growth Metastatic breast factor antagonist; cancer; Non- Protein tyrosine small-cell lung kinase 6 inhibitor; cancer; Papillary RET tyrosine thyroid tumor; kinase receptor Solid tumor; family inhibitor; Squamous cell Src tyrosine carcinoma; kinase inhibitor; Thyroid tumor; Tek tyrosine Transitional cell kinase receptor carcinoma inhibitor; VEGF receptor antagonist; VEGF- 2 receptor antagonist tazemetostat Advanced solid Enhancer of zeste tumor; Diffuse homolog 2 large B-cell inhibitor; Histone lymphoma; lysine Follicle center methyltransferase lymphoma; inhibitor Mesothelioma; Neuroblastoma; Non-Hodgkin lymphoma; Non- small-cell lung cancer; Ovary tumor; Renal cell carcinoma; Sarcoma regorafenib Adenoid tumor; Caspase-3 Biliary cancer; stimulator; Cholangiocarcino- Caspase-9 ma; Esophagus stimulator; FGF tumor; receptor Gastrointestinal antagonist; Kit stromal tumor; tyrosine kinase Hepatocellular inhibitor; PDGF carcinoma; receptor beta Metastatic modulator; RET colorectal cancer; tyrosine kinase Pancreas tumor; receptor family Soft tissue inhibitor; Raf 1 sarcoma; Solid protein kinase tumor; Stomach inhibitor; Raf B tumor protein kinase inhibitor; TIE tyrosine kinase receptor inhibitor; Tek tyrosine kinase receptor inhibitor; VEGF-1 receptor antagonist; VEGF- 2 receptor antagonist; VEGF- 3 receptor antagonist marizomib (iv, Glioma; Multiple Proteasome cancer), Celgene myeloma inhibitor bendamustine Amyloidosis; B- PARP modulator cell lymphoma; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Glioma; Mantle cell lymphoma; Metastatic ovary cancer; Multiple myeloma; Non- Hodgkin lymphoma lenvatinib mesylate Adenocarcinoma; FGF1 receptor Adenoid tumor; antagonist; FGF2 Anaplastic thyroid receptor cancer; Biliary antagonist; FGF3 cancer; Breast receptor tumor; antagonist; FGF4 Endometrioid receptor carcinoma; antagonist; Kit Fallopian tube tyrosine kinase cancer; inhibitor; PDGF Hepatocellular receptor alpha carcinoma; antagonist; PDGF Medullary thyroid receptor beta cancer; antagonist; Ret Metastatic breast tyrosine kinase cancer; receptor inhibitor; Metastatic VEGF-1 receptor colorectal cancer; antagonist; VEGF- Neuroendocrine 2 receptor tumor; Non- antagonist; VEGF- small-cell lung 3 receptor cancer; Ovary antagonist tumor; Peritoneal tumor; Renal cell carcinoma; Sarcoma; Solid tumor; Thyroid tumor tamibarotene Acute Retinoic acid myelogenous receptor alpha leukemia; Acute agonist; Retinoic promyelocytic acid receptor beta leukemia; agonist; Retinoid Fibrosis; receptor agonist Hepatocellular carcinoma; Myelodysplastic syndrome; Neutropenia carboplatin Breast tumor; Esophagus tumor; Head and neck tumor; Lymphoma; Non- small-cell lung cancer; Ovary tumor; Small-cell lung cancer; solid tumor; Stomach tumor; Testis tumor; Uterine cervix tumor INCB-50465 B-cell lymphoma; Phosphoinositide- Follicle center 3 kinase delta lymphoma; inhibitor Myelofibrosis INCB-054828 Cholangiocarcino- FGF receptor ma; antagonist Hematological neoplasm; Lymphoma; Multiple myeloma; Solid tumor; Transitional cell carcinoma crizotinib Anaplastic large ALK tyrosine cell lymphoma; kinase receptor Cancer; family inhibitor; Glioblastoma; Anaplastic Hormone lymphoma kinase refractory receptor inhibitor; prostate cancer; Echinoderm Metastasis; microtubule like Metastatic non protein 4 inhibitor; small cell lung Hepatocyte growth cancer; factor antagonist; Neuroblastoma; MET tyrosine Non-small-cell kinase receptor lung cancer; family inhibitor; Renal cell Ros1 tyrosine carcinoma; kinase receptor Rhabdomyosarco- inhibitor ma; Soft tissue sarcoma; Transitional cell carcinoma; Uveal melanoma carfilzomib AL amyloidosis; Proteasome Acute inhibitor; Ubiquitin lymphoblastic inhibitor leukemia; Chronic lymphocytic leukemia; Cutaneous T-cell lymphoma; Hormone refractory prostate cancer; Macroglobulinemi- a; Mantle cell lymphoma; Multiple myeloma; Neuroendocrine tumor; Non- Hodgkin lymphoma; Peripheral T-cell lymphoma; Renal cell cardinoma; Small-cell lung cancer; Solid tumor tipifamib Chronic Protein myelocytic farnesyltransferase leukemia; inhibitor; Ras Hepatitis D virus GTPase inhibitor infection; Myelodysplastic syndrome; Peripheral T-cell lymphoma; Solid tumor; Transitional cell carcinoma SNS-062 Chronic Btk tyrosine lymphocytic kinase inhibitor leukemia; Lymphoplasmacy- toid lymphoma; Mantle cell lymphoma; Non- Hodgkin lymphoma CUDC-907 Breast tumor; Histone Carcinoma; deacetylase-1 Diffuse large B- inhibitor; Histone cell lymphoma; deacetylase-10 Lymphoma; inhibitor; Histone Multiple deacetylase-2 myeloma; Solid inhibitor; Histone tumor deacetylase-3 inhibitor; Histone deacetylase-6 inhibitor; Phosphoinositide- 3 kinase alpha inhibitor; Phosphoinositide- 3 kinase beta inhibitor; Phosphoinositide- 3 kinase delta inhibitor niraparib Advanced solid Poly ADP ribose tumor; Ewing polymerase 1 sarcoma; inhibitor; Poly ADP Fallopian tube ribose polymerase cancer; Hormone 2 inhibitor refractory prostate cancer; Metastatic breast cancer; Ovary tumor; Peritoneal tumor; Small-cell lung cancer azacitidine (oral, Acute DNA cancer), Celgene myelogenous methyltransferase leukemia; Breast inhibitor tumor; Hematological neoplasm; Lymphoma; Metastatic non small cell lung cancer; Myelodysplastic syndrome; Solid tumor; Stage IV melanoma alvocidib Acute Cyclin-dependent myelogenous kinase-4 inhibitor; leukemia; Cyclin-dependent Myelodysplastic kinase-6 inhibitor; syndrome Cyclin-dependent kinase-9 inhibitor iberdomide Multiple DNA binding myeloma; protein lkaros Systemic lupus inhibitor; Protein erythematosus cereblon modulator; Zinc finger binding protein Aiolos inhibitor midostaurin Acute Flt3 tyrosine myelogenous kinase inhibitor; leukemia; Kit tyrosine kinase Systemic inhibitor; Protein mastocytosis kinase C inhibitor lenalidomide Acute myelogenous leukemia; Adult T-cell lymphoma; Amyloidosis; B- cell acute lymphoblastic leukemia; Bladder cancer; Chronic lymphocytic leukemia; Cutaneous T-cell lymphoma; Follicle center lymphoma; Histinocytosis; Hodgkins disease; Immune disorder; Macroglobulinemi- a; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastatic non small cell lung cancer; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; POEMS syndrome; Peripheral T-cell lymphoma; Solid tumor; T-cell lymphoma abemaciclib Advanced solid Cyclin-dependent tumor; Cancer; kinase-4 inhibitor; Glioblastoma; Cyclin-dependent Mantle cell kinase-6 inhibitor lymphoma; Metastasis; Metastatic breast cancer; Metastatic pancreas cancer; Non-small-cell lung cancer; Stomach tumor vincristine sulfate Acute lymphoblastic leukemia; Diffuse large B-cell lymphoma; Leukemia; Non- Hodgkin lymphoma Busulfex Bone marrow transplantation; Hodgkins disease; Non- Hodgkin lymphoma ASN-002, Asana Atopic dermatitis; JAK tyrosine Biosciences Inflammatory kinase inhibitor disease; Syk tyrosine Lymphoma; Solid kinase inhibitor; tumor Unspecified protein kinase inhibitor remetinostat Alopecia areata; Histone Cutaneous T-cell deacetylase-1 lymphoma; inhibitor; Histone Psoriasis deacetylase-2 inhibitor; Histone deacetylase-3 inhbitor; Histone deacetylase-6 inhibitor ixazomib citrate Amyloidosis; Proteasome (oral, multiple Bladder inhibitor myeloma/ cancer; amyloidosis), Breast tumor; Millennium HIV infection; Hematological neoplasm; Lupus nephritis; Lymphoma; Macroglobulinemi- a; Multiple myeloma fludarabine Acute DNA polymerase myelogenous alpha inhibitor; leukemia; DNA primase Chronic inhibitor; lymphocytic Ribonucleotide leukemia; reductase inhibitor Chronic myelocytic leukemia; Mantle cell lymphoma; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma ganetespib Hsp 90 inhibitor; Jak2 tyrosine kinase inhibitor; Kit tyrosine kinase inhibitor; STAT-3 inhibitor; STAT-5 inhibitor sirolimus Chondrosarcoma; mTOR inhibitor Graft versus host disease; Kidney transplant rejection; Liposarcoma; Lymphangioleiomyo- tosis; Sytstemic lupus erythematosus; Tuberous sclerosis radium Ra 223 Bone dichloride metastases; Breast tumor; Cancer; Hormone refractory prostate cancer; Metastatic breast cancer; Metastatic renal cancer; Multiple myeloma; Osteosarcoma

In some embodiments, the therapeutic agent is one of those in Table 7, below; or a pharmaceutically acceptable salt thereof.

TABLE 7 Exemplary Therapeutic Agents and Associated Diseases and Disorders Active Target-based Drug Name Indications Actions Structure sofosbuvir + Hepatitis C virus Hepatitis C virus ledipasvir (fixed- infection NS5B polymerase combination, HCV), inhibitor; Hepatitis Gilead C virus protein NS5A inhibitor lenalidomide Acute myelogenous leukemia; Adult T-cell lymphoma; Amyloidosis; B- cell acute lymphoblastic leukemia; Bladder cancer;

Chronic lymphocytic leukemia; Cutaneous T-cell lymphoma; Follicle center lymphoma; Histiocytosis; Hodgkins disease; Immune disorder; Macroglobulinemia; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastatic non small cell lung cancer; Multiple myeloma; Myelodysplastic syndrome; Non-Hodgkin lymphoma; POEMS syndrome; Peripheral T-cell lymphoma; Solid tumor; T-cell lymphoma fluticasone Asthma; Chronic Beta 2 propionate + obstructive adrenoceptor salmeterol (asthma pulmonary agonist and COPD), disease GlaxoSmithKline sofosbuvir Hepatitis C virus Hepatitis C virus infection NS5B polymerase inhibitor dimethyl fumarate Demyelinating Kelch like ECH disease; Multiple associated protein sclerosis; 1 modulator; Scleroderma Nuclear erythroid 2-related factor 2 stimulator budesonide + Asthma; Chronic Beta 2 formoterol fumarate, obstructive adrenoceptor AstraZeneca pulmonary agonist disease fingolimod Multiple sclerosis; Cannabinoid Optic neuritis; receptor Rett syndrome; antagonist; Uveitis Sphingosine-1- phosphate receptor-1 modulator ibrutinib Acute Btk tyrosine myelogenous kinase inhibitor leukemia; Allergic rhinitis; Autoimmune disease; B-cell acute lymphoblastic leukemia; B-cell lymphoma: Breast tumor; Carcinoid tumor; Chronic lymphocytic leukemia; Colorectal tumor; Diffuse large B- cell lymphoma; Follicle center lymphoma; Graft versus host disease; Hairy cell leukemia; Lymphoplasmacytoid lymphoma; Macroglobulinemia; Mantle cell lymphoma; Marginal zone B- cell lymphoma; Metastatic non small cell lung cancer; Metastatic renal cancer; Multiple myeloma; Neuroendocrine tumor; Non- Hodgkin lymphoma; Pancreas tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Systemic mastocytosis; T- cell lymphoma; Transitional cell carcinoma esomeprazole Bleeding; H+ K+ ATPase Duodenal ulcer; inhibitor Esophagitis; Gastroesophageal reflux; Helicobacter pylori infection; Peptic ulcer; Zollinger-Ellison syndrome bortezomib Acute 26S proteasome lymphoblastic complex inhibitor; leukemia; Acute Proteasome myelogenous inhibitor leukemia; Breast tumor; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Graft versus host disease; Head and neck tumor; Hormone refractory prostate cancer. Kidney transplant rejection; Macroglobulinemia; Mantle cell lymphoma; Multiple myeloma; Myelodysplastic syndrome; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Solid tumor; Squamous cell carcinoma; Stage IV melanoma everolimus Acute mTOR complex 1 lymphoblastic inhibitor; mTOR leukemia; inhibitor Advanced solid tumor; Angiomyolipoma; Astrocytoma; Bladder cancer; Breast tumor; Colorectal tumor; Cutaneous T-cell lymphoma; Diffuse large B- cell lymphoma; Endometrioid carcinoma; Epilepsy; Esophagus tumor; Glioma; Head and neck tumor; Heart transplant rejection; Kidney transplant rejection; Liver transplant rejection; Lung transplant rejection; Macroglobulinemia; Medullary thyroid cancer; Metastatic breast cancer; Metastatic renal cancer; Multiple hamartoma sydrome; Neuroendocrine tumor; Neurofibromatosis type I; Non- Hodgkin lymphoma; Non- small-cell lung cancer; Pancreatic endocrine tumor; Renal cell carcinoma; Solid tumor; Stomach tumor; Thyroid tumor; Transplant rejection; Uveal melanoma tacrolimus Bone marrow Calcineurin transplantation; inhibitor Heart transplantation; IgA nephropathy; Kidney transplantation; Liver transplantation; Lung transplantation; Lupus nephritis; Myasthenia gravis; Pneumonia; Rheumatoid arthritis; Transplant rejection; Ulcerative colitis sofosbuvir + Hepatitis C virus Hepatitis C virus velpatasvir (fixed infection; Liver NS5B polymerase dose combination, cirrhosis inhibitor; Hepatitis HCV), Gilead C virus protein NS5A inhibitor paritaprevir + Hepatitis C virus ritonavir + NS3 protease ombitasvir (oral, inhibitor; Hepatitis HCV infection) C virus NS5B AbbVie polymerase inhibitor; Hepatitis C virus protein NS5A inhibitor teriflunomide Multiple sclerosis Dihydroorotate dehydrogenase inhibitor ruxolitinib (oral, Acute Jak1 tyrosine myeloproliferative lymphoblastic kinase inhibitor; disorders), leukemia; Acute Jak2 tyrosine Incyte/Novartis myelogenous kinase inhibitor leukemia; B-cell lymphoma; Breast disease; Cachexia; Chronic lymphocytic leukemia; Chronic myelocytic leukemia; Graft versus host disease; Head and neck tumor; Hodgkins disease; Leukemia; Metastatic breast cancer; Myelofibrosis; Polycythemia vera; Splenomegaly; T- cell lymphoma; Thalassemia major; Thrombocythemia montelukast sodium Allergic rhinitis; Leukotriene D4 Asthma antagonist pomalidomide AL amyloidosis; Cancer; Multiple myeloma; Myelofibrosis; Scleroderma entecavir Hepatitis B virus DNA polymerase infection inhibitor tenofovir disoproxil HIV infection; NA polymerase fumarate HIV-1 infection; inhibitor; HIV-1 Hepatitis B virus reverse infection transcriptase inhibitor budesonide (inhaled Allergic rhinitis; formulations), Asthma; Chronic AstraZeneca obstructive pulmonary disease; Nasal polyps celecoxib Ankylosing Cyclooxygenase 2 spondylitis; Back inhibitor pain; Breast tumor; Dysmenorrhea; Familial adenomatous polyposis; Osteoarthritis; Pain; Periarthritis; Rheumatoid arthritis; Tenosynovitis salbutamol, Asthma; Beta 2 GlaxoSmith Kline Bronchospasm; adrenoceptor Chronic agonist obstructive pulmonary disease apremilast Ankylosing PDE 4 inhibitor spondylitis; Behcets disease; Hidradenitis suppurativa; Psoriasis; Psoriatic arthritis; Ulcerative colitis duloxetine Back pain; Chronic fatigue syndrome; Depression; Diabetic peripheral neuropathy; Fibromyalgia; Generalized anxiety disorder; Lower back pain; Major depressive disorder; Musculoskeletal pain; Obsessive compulsive disorder; Osteoarthritis; Stress urinary incontinence tofacitinib citrate Discoid lupus JAK tyrosine (oral, inflammation), erythematosus; kinase inhibitor; Pfizer Juvenile Jak1 tyrosine rheumatoid kinase inhibitor; arthritis; Jak3 tyrosine Psoriasis; kinase inhibitor Psoriatic arthritis; Rheumatoid arthritis; Systemic lupus erythematosus; Ulcerative colitis fluticasone Allergic rhinitis; propionate Asthma fluticasone furoate + Asthma; Chronic vilanterol trifenatate obstructive (oral inhalant, pulmonary asthma/COPD), disease GlaxoSmith Kline lansoprazole Duodenal ulcer; H+ K+ ATPase Esophagitis; inhibitor Gastroesophageal reflux; Gastrointestinal disease; Helicobacter pylori infection; Peptic ulcer; Stomach ulcer; Ulcer; Zollinger- Ellison syndrome pirfenidone Cardiac failure; PDGF receptor Idiopathic antagonist; TGF pulmonary beta antagonist; fibrosis p38 MAP kinase inhibitor mesalazine (oral Irritable bowel sustained release, syndrome; MMX), Ulcerative colitis Giuliani/Shire/ Mochida/Pacific amoxicillin + Abdominal Beta lactamase clavulanate abscess; Acute inhibitor potassium, GSK bronchitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bone and joint infection; Bronchitis; Cellulitis; Cystitis; Enterobacter infection; Escherichia coli infection; Female genital tract infection; Haemophilus influenzae infection; Haemophilus parainfluenzae infection; Infectious disease; Klebsiella infection; Klebsiella pneumoniae infection; Laryngitis; Lower respiratory tract infection; Lymphangitis; Mastoiditis; Moraxella catarrhalis infection; Neisseria gonorrhoeae infection; Osteomyelitis; Otitis media; Pelvic inflammatory disease; Pharyngitis; Prophylaxis; Pyelonephritis; Sinusitis; Staphylococcus aureus infection; Tonsillitis drospirenone + Acne; Estradiol agonist; ethinylestradiol, Dysmenorrhea; Progesterone Schering AG Endometriosis; receptor agonist Female contraception; Folic acid deficiency; Premenstrual syndrome mycophenolate Heart transplant Inosine mofetil rejection; IgA monophosphate nephropathy; dehydrogenase Interstitial lung inhibitor; PurH disease; Kidney purine transplant biosynthesis rejection; Liver protein inhibitor transplant rejection; Lung transplant rejection; Lupus nephritis; Pancreas transplant rejection; Pemphigus; Scleroderma; Transplant rejection bendamustine Amyloidosis; B- PARP modulator cell lymphoma; Chronic lymphocytic leukemia; Diffuse large B-cell lymphoma; Glioma; Mantle cell lymphoma; Metastatic ovary cancer; Multiple myeloma; Non- Hodgkin lymphoma dexlansoprazole Esophagitis; H+ K+ ATPase (oral controlled- Gastroesophageal inhibitor release), Takeda reflux carfilzomib AL amyloidosis; Proteasome Acute inhibitor; Ubiquitin lymphoblastic inhibitor leukemia; Chronic lymphocytic leukemia; Cutaneous T-cell lymphoma; Hormone refractory prostate cancer; Macroglobulinemia; Mantle cell lymphoma; Multiple myeloma; Neuroendocrine tumor; Non- Hodgkin lymphoma; Peripheral T-cell lymphoma; Renal cell carcinoma; Small-cell lung cancer; Solid tumor diclofenac, Novartis Ankylosing Cyclooxygenase spondylitis; inhibitor Dysmenorrhea; Inflammatory disease; Keratosis; Ocular inflammation; Osteoarthritis; Pain; Rheumatoid arthritis voriconazole Aspergillus Lanosterol-14 fumigatus demethylase infection; inhibitor Aspergillus infection; Candida infection; Candida krusei infection; Cryptococcus neoformans meningitis; Dermatomycosis; Fungal infection; Fungal urinary tract infection; Fusarium infection; Scedosporium infection febuxostat Gout; Xanthine oxidase Hyperuricemia; inhibitor Tumor lysis syndrome fampridine (oral, Multiple sclerosis Potassium sustained release, channel inhibitor multiple sclerosis/ spinal cord injury), Acorda/Biogen salbutamol MDI, Asthma; Beta 2 IVAX Corp Bronchospasm; adrenoceptor Chronic agonist obstructive pulmonary disease ertapenem Bacterial Penicillin binding infection; protein inhibitor Bacterial pneumonia; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides fragilis infection; Bacteroides infection; Clostridium infection; Diabetic foot ulcer; Escherichia coli infection; Female genital tract infection; Gram negative bacterium infection; Gram positive bacterium infection; Haemophilus influenzae infection; Klebsiella pneumoniae infection; Moraxella catarrhalis infection; Prophylaxis; Proteus mirabilis infection; Pyelonephritis; Sepsis; Staphylococcus aureus infection; Streptococcus agalactiae infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection caspofungin Abdominal 1,3 beta glucan abscess; synthase inhibitor Aspergillus infection; Candida infection; Fungal infection; Peritonitis grazoprevir + Hepatitis C virus Hepatitis C virus elbasvir (oral/FDC infection NS3 protease tablet, HCV inhibitor; Hepatitis infection), Merck C virus protein NS5A inhibitor mometasone furoate Allergic rhinitis; (nasal), Merck & Co Nasal polyps; Perennial allergic rhinitis; Seasonal allergic rhinitis amphotericin B Absidia infection; (liposomal iv, Aspergillus visceral infection; leishmaniasis), Blastomyces Drugs for Neglected infection; Diseases initiative Candida infection; Cladophialophora infection; Coccidioides infection; Cryptococcus infection; Cryptococcus neoformans meningitis; Exophiala infection; Fungal infection; Fungal meningitis; Fungal respiratory tract infection; Histoplasma infection; Leishmania donovani infection; Mucor infection; Rhizomucor infection; Rhizopus infection beclomethasone Asthma Glucocorticoid dipropionate, (CFC- agonist free), Teva mesalazine (oral/rectal controlled-release), Ferring Crohns disease; Ulcerative colitis

etoricoxib Ankylosing Cyclooxygenase 2 spondylitis; Gout; inhibitor Osteoarthritis; Pain; Rheumatoid arthritis loxoprofen Inflammatory Cyclooxygenase disease; Pain inhibitor; Prostanoid receptor antagonist mometasone + Asthma Beta 2 formoterol (inhaled, adrenoceptor asthma), Merck & agonist Co colchicine (oral, Carditis; Familial gout/familial mediterranean Mediterranean fever; Gout fever), Takeda rabeprazole Gastritis; H+ K+ ATPase Gastroesophageal inhibitor reflux; Gastrointestinal ulcer; Helicobacter pylori infection; Peptic ulcer; Zollinger-Ellison syndrome moxifloxacin Abdominal DNA gyrase abscess; Acute inhibitor; bronchitis; Acute Topoisomerase IV sinusitis; inhibitor Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacteroides fragilis infection; Bacteroides infection; Chlamydia pneumoniae infection; Clostridiaceae infection; Clostridium infection; Enterobacter infection; Enterococcus faecalis infection; Escherichia coli infection; Haemophilus infection; Haemophilus influenzae infection; Klebsiella pneumoniae infection; Moraxella catarrhalis infection; Multidrug resistant infection; Mycobacterium tuberculosis infection; Mycoplasma infection; Pelvic inflammatory disease; Proteus mirabilis infection; Salpingitis; Staphylococcus aureus infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Yersinia pestis infection estradiol (vaginal Atrophic vaginitis; Estradiol agonist cream, HRT), Menopause Bristol-Myers Squibb enteric-coated Kidney transplant Inosine mycophenolate rejection; Lupus monophosphate sodium, Novartis nephritis; dehydrogenase Nephrotic inhibitor syndrome fluticasone furoate Allergic rhinitis Glucocorticoid (nasal, allergic agonist rhinitis), GSK mesalazine Ulcerative colitis; Cyclooxygenase (oral/rectal Ulcerative inhibitor extended-release), proctitis Dr Falk limaprost Spinal stenosis; PGE1 agonist Thromboangiitis obliterans diclofenac (fast Osteoarthritis Cyclooxygenase penetration topical inhibitor formulation), Nuvo/ Horizon Pharma ceftriaxone Abscess; Acinetobacter infection; Acute bronchitis; Bacterial infection; Bacterial meningitis; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides fragilis infection; Bacteroides infection; Bartholinitis; Bone and joint infection; Cellulitis; Cervicitis; Cholangitis; Cholecystitis; Citrobacter infection; Clostridium infection; Corneal ulcer; Cystitis; Empyema; Enterobacter infection; Epididymitis; Escherichia coli infection; Haemophilus infection; Haemophilus influenzae infection; Klebsiella infection; Klebsiella pneumoniae infection; Laryngitis; Lung abscess; Moraxella catarrhalis infection; Morganella infection; Morganella morganii infection; Neisseria gonorrhoeae infection; Neisseria meningitidis meningitis; Otitis media; Pelvic inflammatory disease; Peritonitis; Pharyngitis; Prevotella infection; Proctitis; Prophylaxis; Proteus infection; Proteus mirabilis infection; Providencia infection; Pseudomonas aeruginosa infection; Pyelonephritis; Sepsis; Serratia infection; Sinusitis; Staphylococcus aureus infection; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Tonsillitis; Urethritis; Uterus infection imipenem + Abscess; Dehydropeptidase cilastatin Acinetobacter −1 inhibitor infection; Acute bronchitis; Appendicitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides fragilis infection; Bacteroides infection; Bartholinitis; Bifidobacterium infection; Bone and joint infection; Cellulitis; Cholangitis; Cholecystitis; Citrobacter infection; Clostridium infection; Complicated urinary tract infection; Corneal ulcer; Cystitis; Empyema; Endocarditis; Endophthalmitis; Enterobacter infection; Enterococcus faecalis infection; Escherichia coli infection; Female genital tract infection; Gram negative bacterium infection; Gram positive bacterium infection; Haemophilus infection; Haemophilus influenzae infection; Infectious arthritis; Keratitis; Klebsiella infection; Klebsiella pneumoniae infection; Morganella infection; Osteomyelitis; Panophthalmitis; Pelvic inflammatory disease; Peritonitis; Prostatitis; Proteus infection; Providencia infection; Pseudomonas aeruginosa infection; Pyelonephritis; Sepsis; Serratia infection; Skin ulcer; Staphylococcus aureus infection; Staphylococcus infection; Streptococcus agalactiae infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection omeprazole Duodenal ulcer; H+ K+ ATPase Endocrine tumor; inhibitor Esophagitis; Gastroesophageal reflux; Helicobacter pylori infection; Stomach ulcer; Zollinger-Ellison syndrome azithromycin Abscess; Acute sinusitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bronchitis; Chlamydia pneumoniae infection; Chlamydia trachomatis infection; Chronic obstructive pulmonary disease; Female genital tract infection; Genital tract infection; Genital ulcer; Haemophilus ducreyi infection; Haemophilus influenzae infection; Legionella pneumophila infection; Moraxella catarrhalis infection; Mycobacterium infection; Mycoplasma infection; Neisseria gonorrhoeae infection; Otitis media; Pelvic inflammatory disease; Pharyngitis; Prophylaxis; Staphylococcus aureus infection; Streptococcus agalactiae infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Tonsillitis; Urethritis dexamethasone Diabetic macular (sustained release edema; Macular ophthalmic), edema; Ocular Allergan/Sanwa inflammation; Retinal venous occlusion; Uveitis piperacillin + Abdominal Beta lactamase tazobactam abscess; inhibitor (injectable), Abscess; Wyeth/Toyama/ Acinetobacter Taiho infection; Appendicitis; Bacterial infection; Bacterial pneumonia; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides fragilis infection; Bacteroides infection; Cellulitis; Cholangitis; Cholecystitis; Cystitis; Diabetic foot ulcer; Escherichia coli infection; Febrile neutropenia; Haemophilus influenzae infection; Klebsiella pneumoniae infection; Lower respiratory tract infection; Pelvic inflammatory disease; Peritonitis; Pseudomonas aeruginosa infection; Pyelonephritis; Sepsis; Staphylococcus aureus infection fexofenadine Atopic dermatitis; Histamine H1 Pruritus; receptor Seasonal allergic antagonist rhinitis; Urticaria meropenem Appendicitis; Penicillin binding Bacterial protein inhibitor infection; Bacterial meningitis; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides fragilis infection; Bacteroides infection; Bacteroides thetaiotaomicron infection; Complicated skin and skin structure infection; Complicated urinary tract infection; Cystic fibrosis; Enterococcus faecalis infection; Escherichia coli infection; Haemophilus influenzae infection; Klebsiella pneumoniae infection; Neisseria meningitidis meningitis; Peptostreptococcus infection; Peritonitis; Pneumonia; Proteus mirabilis infection; Pseudomonas aeruginosa infection; Staphylococcus aureus infection; Streptococcus agalactiae infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; viridans group Streptococcus infection gabapentin Epilepsy; Motor neurone disease; Neuropathic pain; Osteoarthritis; Postherpetic neuralgia bepotastine Allergic rhinitis; Histamine H1 Allergy; Atopic receptor dermatitis; antagonist Perennial allergic rhinitis; Pruritus ibuprofen + Arthritis; Pain Histamine H2 famotidine receptor (oral/tablet, antagonist pain/arthritis/gastric ulcer), Horizon levofloxacin Abscess; Acute DNA gyrase bronchitis; Acute inhibitor; sinusitis; Bacillus Topoisomerase IV anthracis inhibitor infection; Bacterial infection; Bacterial pneumonia; Bacterial skin infection; Bacterial urinary tract infection; Brucella infection; Cellulitis; Chlamydia pneumoniae infection; Cholangitis; Cholecystitis; Cystitis; Enterobacter cloacae infection; Enterococcus faecalis infection; Epididymitis; Escherichia coli infection; Haemophilus influenzae infection; Haemophilus parainfluenzae infection; Impetigo; Klebsiella pneumoniae infection; Legionella pneumophila infection; Moraxella catarrhalis infection; Multidrug resistant infection; Mycobacterium tuberculosis infection; Mycoplasma pneumoniae infection; Peritonitis; Prostatitis; Proteus mirabilis infection; Pseudomonas aeruginosa infection; Pyelonephritis; Pyoderma gangrenosum; Serratia marcescens infection; Staphylococcus aureus infection; Staphylococcus epidermidis infection; Staphylococcus saprophyticus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Yersinia pestis infection sirolimus Chondrosarcoma; mTOR inhibitor Graft versus host disease; Kidney transplant rejection; Liposarcoma; Lymphangioleiomyomatosis; Systemic lupus erythematosus; Tuberous sclerosis idelalisib AL amyloidosis; Phosphoinositide- Chronic 3 kinase delta lymphocytic inhibitor leukemia; Follicle center lymphoma; Macroglobulinemia; Mantle cell lymphoma; Myelofibrosis; Non-Hodgkin lymphoma; Pancreatic ductal adenocarcinoma cetirizine Allergic rhinitis; Histamine H1 Pruritus; Urticaria receptor antagonist budesonide (oral Ulcerative colitis controlled-release gastrointestinal- specific (MMX), ulcerative colitis), Cosmo/Ferring/Salix thalidomide, Multiple Celgene myeloma; Mycobacterium leprae infection lamivudine HIV infection; DNA polymerase Hepatitis B virus inhibitor; HIV-1 infection reverse transcriptase inhibitor; Nucleoside reverse transcriptase inhibitor; RNA DNA polymerase inhibitor pranlukast Allergic rhinitis; Leukotriene C4 Asthma antagonist; Leukotriene D4 antagonist; Leukotriene E4 antagonist; P- Glycoprotein inhibitor salmeterol Asthma; Chronic Beta 2 obstructive adrenoceptor pulmonary agonist; Beta disease adrenoceptor agonist naproxen + Ankylosing Cyclooxygenase esomeprazole (oral spondylitis; inhibitor; H+ K+ fixed-dose Juvenile ATPase inhibitor combination, rheumatoid inflammatory pain), arthritis; AstraZeneca/Aralez Osteoarthritis; Pain; Rheumatoid arthritis levocetirizine Allergic rhinitis; Histamine H1 Allergy; Perennial receptor allergic rhinitis; antagonist Pruritus; Seasonal allergic rhinitis; Urticaria fluconazole Balanitis; Lanosterol-14 Candida demethylase infection; inhibitor Cryptococcus infection; Cryptococcus neoformans meningitis; Dermatomycosis; Female genital tract infection; Fungal infection; Fungal respiratory tract infection; Fungal urinary tract infection; Prophylaxis; Tinea capitis; Tinea corporis; Tinea cruris; Tinea pedis clarithromycin Abscess; Acute bronchitis; Acute sinusitis; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bordetella pertussis infection; Campylobacter infection; Cervicitis; Chlamydia infection; Chlamydia pneumoniae infection; Chronic bronchitis; Enterocolitis; Haemophilus influenzae infection; Haemophilus parainfluenzae infection; Helicobacter pylori infection; Laryngitis; Legionella infection; Lymphadenitis; Lymphangitis; Moraxella catarrhalis infection; Mycobacterium infection; Mycoplasma infection; Otitis media; Peptostreptococcus infection; Pericoronitis; Periodontitis; Pharyngitis; Prophylaxis; Sinusitis; Staphylococcus aureus infection; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Streptococcus pyogenes infection; Tonsillitis; Urethritis gemcitabine Biliary cancer; Bladder tumor; Breast tumor; Cancer; Carcinoma; Hepatobiliary system tumor; Lymphoma; Metastatic breast cancer; Metastatic non small cell lung cancer; Metastatic pancreas cancer; Non-small-cell lung cancer; Ovary tumor; Pancreas tumor; Renal cell carcinoma simeprevir Hepatitis C virus Hepatitis C virus infection NS3 protease inhibitor cefcapene Abscess; Acute Penicillin binding bronchitis; protein inhibitor Bacterial eye infection; Bacterial infection; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides infection; Bartholinitis; Cervicitis; Cholangitis; Cholecystitis; Citrobacter infection; Cystitis; Dacryocystitis; Enterobacter infection; Escherichia coli infection; Haemophilus influenzae infection; Jaw disease; Klebsiella infection; Laryngitis; Lymphangitis; Mastitis; Moraxella catarrhalis infection; Morganella morganii infection; Neisseria gonorrhoeae infection; Otitis externa; Otitis media; Pelvic inflammatory disease; Peptostreptococcus infection; Pericoronitis; Periodontal disease; Pharyngitis; Prevotella infection; Propionibacterium acnes infection; Proteus infection; Providencia infection; Pyelonephritis; Respiratory disease; Serratia infection; Sinusitis; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Tonsillitis; Urethritis; Uterus infection garenoxacin Acute bronchitis; DNA gyrase Bacterial inhibitor; infection; Topoisomerase IV Bacterial inhibitor pneumonia; Bacterial respiratory tract infection; Chlamydia pneumoniae infection; Enterobacter infection; Escherichia coli infection; Haemophilus influenzae infection; Klebsiella infection; Laryngopharyngitis; Legionella pneumophila infection; Moraxella catarrhalis infection; Mycoplasma infection; Otitis media; Peritonsillitis; Sinusitis; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Tonsillitis tazarotene (topical, Acne; Aging; Retinoic acid psoriasis/acne), Psoriasis receptor agonist Allergan pimecrolimus Atopic dermatitis Calcineurin inhibitor; IL-10 antagonist; IL-2 antagonist; IL-4 antagonist; Interferon gamma receptor antagonist epinastine Allergic Histamine H1 hydrochloride conjunctivitis receptor (topical ophthalmic antagonist formulation), Allergan hyaluronate sodium Osteoarthritis; Rheumatoid arthritis vancomycin Bacterial Peptidoglycan infection; recognition protein Bacterial inhibitor pneumonia; Clostridium difficile infection; Enterocolitis; MRSA infection; Osteomyelitis; Prophylaxis; Pseudomembranous colitis; Sepsis; Staphylococcus aureus infection; Staphylococcus infection; Streptococcus pneumoniae infection adefovir dipivoxil Hepatitis B virus DNA polymerase infection inhibitor; Nucleoside reverse transcriptase inhibitor vonoprazan Duodenal ulcer; H+ K+ ATPase fumarate (oral, Esophagitis; inhibitor GERD/peptic ulcer), Gastroesophageal Takeda reflux; Helicobacter pylori infection; Peptic ulcer; Stomach ulcer mosapride Gastritis 5-HT 4 receptor agonist ursodeoxycholic Cholelithiasis; acid Hepatitis; Liver disease; Primary biliary cirrhosis betamethasone Dermatitis; Discoid lupus erythematosus; Eczema; Lichen; Prurigo; Psoriasis fluticasone propionate + Asthma; Chronic Beta 2 formoterol fumarate obstructive adrenoceptor (asthma/COPD, pulmonary agonist HFA-MDI), disease SkyePharma prednisone (oral, Inflammatory Glucocorticoid delayed release), disease; agonist Horizon/ Rheumatoid Mundipharma arthritis; Systemic lupus erythematosus camostat mesylate Gastroesophageal Serine protease reflux; inhibitor; Trypsin Pancreatitis inhibitor pralatrexate B-cell lymphoma; DHFR inhibitor; Bladder tumor; Folate antagonist Breast tumor; Folate transporter Cutaneous T-cell 1 modulator lymphoma; Esophagus tumor; Fallopian tube cancer; Head and neck tumor; Multiple myeloma; Non- small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Peritoneal tumor; Stomach tumor dimethyl fumarate + Psoriasis ethyl hydrogen fumarate calcium + ethyl hydrogen fumarate magnesium + ethyl hydrogen fumarate zinc ospemifene Atrophic vaginitis; Estrogen receptor Dyspareunia modulator loratadine Allergy; Pruritus; Histamine H1 Rhinitis; Urticaria receptor antagonist flomoxef, Shionogi Abdominal abscess; Acute bronchitis; Bacterial endocarditis; Bacterial infection; Bacterial skin infection; Bacteroides infection; Cholangitis; Cholecystitis; Cystitis; Escherichia coli infection; Female genital tract infection; Haemophilus influenzae infection; Klebsiella infection; Laryngitis; Moraxella catarrhalis infection; Morganella morganii infection; Neisseria gonorrhoeae infection; Otitis media; Peptostreptococcus infection; Peritonitis; Pharyngitis; Prevotella infection; Prostatitis; Proteus infection; Providencia infection; Pyelonephritis; Sepsis; Sinusitis; Staphylococcus infection; Streptococcus infection; Streptococcus pneumoniae infection; Tonsillitis; Urethritis; Uterus infection ixazomib citrate Amyloidosis; Proteasome (oral, multiple Bladder cancer; inhibitor myeloma/amyloidosis), Breast tumor; Millennium HIV infection; Hematological neoplasm; Lupus nephritis; Lymphoma; Macroglobulinemia; Multiple myeloma doripenem Abdominal Penicillin binding abscess; protein inhibitor Abscess; Acinetobacter baumanii infection; Acinetobacter infection; Bacterial infection; Bacterial meningitis; Bacterial pneumonia; Bacterial respiratory tract infection; Bacterial skin infection; Bacterial urinary tract infection; Bacteroides caccae infection; Bacteroides fragilis infection; Bacteroides infection; Bacteroides thetaiotaomicron infection; Bacteroides uniformis infection; Bacteroides vulgatus infection; Cellulitis; Cholangitis; Cholecystitis; Citrobacter infection; Corneal ulcer; Cystitis; Empyema; Endophthalmitis; Enterobacter infection; Enterococcus infection; Epididymitis; Escherichia coli infection; Haemophilus influenzae infection; Infectious arthritis; Infectious endocarditis; Keratitis; Klebsiella infection; Klebsiella pneumoniae infection; Laryngopharyngitis; Liver abscess; Moraxella catarrhalis infection; Morganella infection; Osteomyelitis; Otitis media; Panophthalmitis; Peptostreptococcus infection; Peritonitis; Prevotella infection; Prostatitis; Proteus infection; Proteus mirabilis infection; Providencia infection; Pseudomonas aeruginosa infection; Pyelonephritis; Respiratory tract infection; Sepsis; Serratia infection; Stomach infection; Streptococcus constellatus infection; Streptococcus infection; Streptococcus intermedius infection; Streptococcus pneumoniae infection; Tonsillitis; Uterus infection diclofenac Dysmenorrhea; Cyclooxygenase 2 potassium Inflammatory inhibitor (immediate-release, disease; oral powder), Migraine; Pain Novartis/Depomed/ Tribute dexamethasone Allergic rhinitis Glucocorticoid cipecilate agonist fluticasone furoate Asthma Glucocorticoid (inhaled, respiratory agonist disorders), GlaxoSmithKline obeticholic acid Alcoholic Farnesoid X hepatitis; Biliary receptor agonist atresia; Diarrhea; Liver disease; Non-alcoholic steatohepatitis; Portal hypertension; Primary biliary cirrhosis; Primary sclerosing cholangitis amifampridine Lambert-Eaton Potassium phosphate syndrome; channel inhibitor Muscle weakness; Myasthenia gravis; Nystagmus; Orthostatic hypotension; Renal failure melphalan AL amyloidosis; (intravenous/Captiso Multiple myeloma I, multiple myeloma), Spectrum/CASI Pharmaceuticals irinotecan Brain tumor; Topoisomerase I Breast tumor; inhibitor Colorectal tumor; Lung tumor; Metastatic colorectal cancer; Metastatic pancreas cancer; Non-Hodgkin lymphoma; Ovary tumor; Solid tumor; Squamous cell carcinoma; Stomach tumor; Uterus tumor belinostat (iv, Colorectal tumor; Histone cancer), Hepatocellular deacetylase Onxeo/Spectrum carcinoma; Non- inhibitor small-cell lung cancer; Ovary tumor; Peripheral T-cell lymphoma; Solid tumor ozagrel Asthma Thromboxane hydrochloride (oral, synthetase asthma), Ono/Kissei inhibitor telaprevir Hepatitis C virus Hepatitis C virus infection NS3 protease inhibitor; P- Glycoprotein inhibitor lesinurad Gout; Urate anion Hyperuricemia exchanger 1 inhibitor; Xanthine oxidase inhibitor sofosbuvir + Hepatitis C virus Hepatitis C virus velpatasvir + infection NS3 protease voxilaprevir (fixed inhibitor; Hepatitis dose combination, C virus NS5B HCV), Gilead polymerase inhibitor; Hepatitis C virus protein NS5A inhibitor daclatasvir + Hepatitis C virus Hepatitis C virus asunaprevir + infection NS3 protease beclabuvir (fixed- inhibitor; Hepatitis combination, HCV), C virus NS5B BMS polymerase inhibitor; Hepatitis C virus protein NS5A inhibitor lesinurad + Gout; Urate anion allopurinol Hyperuricemia exchanger 1 (hyperuricaemia in inhibitor; Xanthine gout), AstraZeneca oxidase inhibitor copanlisib Advanced solid Phosphoinositide tumor; Breast 3-kinase inhibitor tumor; Cholangiocarcinoma; Diffuse large B-cell lymphoma; Endometrioid carcinoma; Follicle center lymphoma; Marginal zone B- cell lymphoma; Non-Hodgkin lymphoma; Peripheral T-cell lymphoma; Splenic marginal zone lymphoma budesonide (rectal Rectosigmoiditis; Glucocorticoid foam, ulcerative Ulcerative colitis; agonist colitis), Dr Falk Ulcerative Pharma/Salix/ proctitis Ajinomoto/ EA Pharma baricitinib Atopic dermatitis; Jak1 tyrosine Inflammatory kinase inhibitor; disease; Psoriatic Jak2 tyrosine arthritis; kinase inhibitor Rheumatoid arthritis; Systemic lupus erythematosus sirolimus (injectable Uveitis mTOR inhibitor ophthalmic, uveitis/AMD/DME), Santen crisaborole Atopic dermatitis; PDE 4 inhibitor Psoriasis zoledronic acid Bone metastases; Bone resorption; Breast tumor; Hypercalcemia; Male osteoporosis; Mesothelioma; Metastasis; Multiple myeloma; Osteoarthritis; Osteogenesis imperfecta; Osteoporosis; Pagets bone disease; Postmenopausal osteoporosis desloratadine Allergic rhinitis; Histamine H1 Atopic dermatitis; receptor Perennial allergic antagonist rhinitis; Seasonal allergic rhinitis; Urticaria glecaprevir + Hepatitis C virus Hepatitis C virus pibrentasvir (once- infection N53 protease daily oral tablet, inhibitor; Hepatitis HCV infection), C virus protein AbbVie NS5A inhibitor

2. Definitions

While the terms used herein are believed to be well understood by one of ordinary skill in the art, definitions are set forth herein to facilitate explanation of the presently-disclosed subject matter.

As used herein, the term “about,” when referring to a numerical value or range of a parameter such as mass, weight, volume, time, concentration, biological activity, clogP, or percentage, is meant to encompass variations of, e.g., ±20%, in some embodiments ±10%, in some embodiments ±5%, in some embodiments ±1%, in some embodiments ±0.5%, and in some embodiments ±0.1% from the specified value or range.

As used herein, the terms “treatment,” “treat,” and “treating” refer to reversing, alleviating, delaying the onset of, or inhibiting the progress of a disease or disorder, or one or more symptoms thereof, as described herein. In some embodiments, treatment may be administered after one or more symptoms have developed. In other embodiments, treatment may be administered in the absence of symptoms. For example, treatment may be administered to a susceptible individual prior to the onset of symptoms (e.g., in light of a history of symptoms and/or in light of genetic or other susceptibility factors). Treatment may also be continued after symptoms have resolved, for example to prevent or delay their recurrence.

The term “lipid,” as used herein, refers to natural and non-natural hydrophobic and/or lipophilic fats, oils, polymers, hydrocarbons, and other such materials. In some embodiments, suitable lipids, when incorporated into a lipid prodrug, are processed or metabolized similarly to triglyercides in the GI tract or mimic such processing or metabolism. The term “glyceride” refers to an ester of glycerol (1,2,3-propanetriol) with acyl radicals of fatty acids or other lipids and is also known as an acylglycerol. If only one position of the glycerol molecule is esterified with a fatty acid, a “monoglyceride” is produced; if two positions are esterified, a “diglyceride” is produced; and if all three positions of the glycerol are esterified with fatty acid a “triglyceride” or “triacylglycerol” is produced. A glyceride is called “simple” if all esterified positions contain the same fatty acid; or “mixed” if different fatty acids are involved. The carbons of the glycerol backbone are designated sn-1, sn-2 and sn-3, with sn-2 being in the middle and sn-1 and sn-3 being the ends of the glycerol.

Naturally occurring oils and fats consist largely of triglycerides wherein the 3 fatty acyl residues may or may not be identical. The term “long chain triglycerides” (or “LCT”) means both a simple and mixed triglyceride containing fatty acids with more than 12 carbon atoms (long chain fatty acids, “LCFA”), whereas the term “medium chain triglycerides” (or “MCT”) means both a simple and mixed triglyceride containing fatty acids with 4 to 12 carbon atoms.

The term “ECN” or “equivalent carbon number” means the sum of the number of carbon atoms in the acyl chains of a glyceride molecule. For example, tripalmitin (tripalmitic glycerol), which is a simple triglyceride containing 3 acyl radicals of 16 carbon atoms, has an ECN of 3×16=48. Conversely, a triglyceride with an ECN=40 may have “mixed” acyl chain lengths of 8, 16 and 16; 10, 14 and 16; 8, 14 and 18, etc. Naturally occurring oils are frequently “mixed” with respect to specific fatty acids, but tend not to contain LCFAs and MCFAs on the same glycerol backbone. Thus, triacylglycerols with ECNs of 24-30 typically contain predominately medium chain fatty acids, while triacylglycerols with ECNs of greater than 43 typically contain predominantly long chain fatty acids. Triacylglycerols having an ECNs of 32-42 typically contain one or two MCFA in combination with one or two LCFAs to “fill” the triglyceride. Triacylglycerols with ECNs in the range of greater than 30 to less than 48 typically represent mixed triacylglycerol species that are absent from or are present in significantly lower concentrations in physical mixtures. The fatty acids that occur in foods usually contain an even number of carbon atoms in an unbranched chain, e.g., lauric or dodecanoic acid.

The term “self-immolative group,” as used herein, refers to a bivalent chemical moiety that comprises a covalent, scissile bond as one of its bivalent bonds and a stable, covalent bond with a therapeutic agent as its other bivalent bond, wherein the bond with the therapeutic agent becomes labile upon cleavage of the scissile bond. Examples of self-immolative groups include, but are not limited to, disulfide groups, hydrazones, acetal self-immolative groups, carboxyacetal self-immolative groups, carboxy(methylacetal) self-immolative groups, p-hydroxybenzyl self-immolative groups, para-hydroxybenzyl carbonyl self-immolative groups, flipped ester self-immolative groups, and trimethyl lock, or 2-hydroxyphenyl carbamate (2-HPC) self-immolative groups. A number of other suitable self-immolative groups are known in the art as described, for example, in C. A. Blencowe et al., Polym. Chem. 2011, 2, 773-790 and F. Kratz et al., ChemMedChem. 2008, 3(1), 20-53; Huvelle, S. et al., Org. Biomol. Chem. 2017, 15(16), 3435-3443; and Alouane, A. et al., Angewandte Chemie International Edition 2015, 54 (26), 7492-7509; and Levine, M. N. et al., Chem. Sci. VL-IS-3 (8), 2412-2420; each of which is hereby incorporated by reference in its entirety.

As used here in, the term “therapeutic agent,” “active pharmaceutical agent,” “active agent,” or “pharmaceutical agent” includes any therapeutic agent or imaging (contrasting) agent which would benefit from transport via the intestinal lymphatic system, for example, to enable oral administration (e.g. of an intravenously administered therapeutic agent), to avoid first pass metabolism, avoid liver toxicity or other toxicity, or for targeted delivery within the lymphatic system.

Lipid prodrug compounds of the present invention include those described generally herein, and are further illustrated by the classes, subclasses, and species disclosed herein. As used herein, the following definitions shall apply unless otherwise indicated. For purposes of this invention, the chemical elements are identified in accordance with the Periodic Table of the Elements, Handbook of Chemistry and Physics, 98^(th) Ed. Additionally, general principles of organic chemistry are described in “Organic Chemistry,” Thomas Sorrell, University Science Books, Sausalito: 1999, and March's Advanced Organic Chemistry: Reactions, Mechanisms, and Structure, M. B. Smith and J. March, 7^(th) Edition, John Wiley & Sons, 2013, the entire contents of which are hereby incorporated by reference.

The term “aliphatic” or “aliphatic group,” as used herein, means a straight-chain (i.e., unbranched) or branched, substituted or unsubstituted hydrocarbon chain that is completely saturated or that contains one or more units of unsaturation, or a monocyclic hydrocarbon or bicyclic hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic (also referred to herein as “carbocycle,” “cycloaliphatic” or “cycloalkyl”), that has a single point of attachment to the rest of the molecule. Unless otherwise specified, aliphatic groups contain 1-6 aliphatic carbon atoms. In some embodiments, aliphatic groups contain 1-5 aliphatic carbon atoms. In other embodiments, aliphatic groups contain 1-4 aliphatic carbon atoms. In still other embodiments, aliphatic groups contain 1-3 aliphatic carbon atoms, and in yet other embodiments, aliphatic groups contain 1-2 aliphatic carbon atoms. In some embodiments, “cycloaliphatic” (or “carbocycle” or “cycloalkyl”) refers to a monocyclic C₃-C₆ hydrocarbon that is completely saturated or that contains one or more units of unsaturation, but which is not aromatic, that has a single point of attachment to the rest of the molecule. Suitable aliphatic groups include, but are not limited to, linear or branched, substituted or unsubstituted alkyl, alkenyl, alkynyl groups and hybrids thereof such as (cycloalkyl)alkyl, (cycloalkenyl)alkyl or (cycloalkyl)alkenyl.

As used herein, the term “bicyclic ring” or “bicyclic ring system” refers to any bicyclic ring system, i.e. carbocyclic or heterocyclic, saturated or having one or more units of unsaturation, having one or more atoms in common between the two rings of the ring system. Thus, the term includes any permissible ring fusion, such as ortho-fused or spirocyclic. As used herein, the term “heterobicyclic” is a subset of “bicyclic” that requires that one or more heteroatoms are present in one or both rings of the bicycle. Such heteroatoms may be present at ring junctions and are optionally substituted, and may be selected from nitrogen (including N-oxides), oxygen, sulfur (including oxidized forms such as sulfones and sulfonates), phosphorus (including oxidized forms such as phosphates), boron, etc. In some embodiments, a bicyclic group has 7-12 ring members and 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. As used herein, the term “bridged bicyclic” refers to any bicyclic ring system, i.e. carbocyclic or heterocyclic, saturated or partially unsaturated, having at least one bridge. As defined by IUPAC, a “bridge” is an unbranched chain of atoms or an atom or a valence bond connecting two bridgeheads, where a “bridgehead” is any skeletal atom of the ring system which is bonded to three or more skeletal atoms (excluding hydrogen). In some embodiments, a bridged bicyclic group has 7-12 ring members and 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur. Such bridged bicyclic groups are well known in the art and include those groups set forth below where each group is attached to the rest of the molecule at any substitutable carbon or nitrogen atom. Unless otherwise specified, a bridged bicyclic group is optionally substituted with one or more substituents as set forth for aliphatic groups. Additionally or alternatively, any substitutable nitrogen of a bridged bicyclic group is optionally substituted. Exemplary bicyclic rings include:

Exemplary bridged bicyclics include:

The term “lower alkyl” refers to a C₁₋₄ straight or branched alkyl group. Exemplary lower alkyl groups are methyl, ethyl, propyl, isopropyl, butyl, isobutyl, and tert-butyl.

The term “lower haloalkyl” refers to a C₁₋₄ straight or branched alkyl group that is substituted with one or more halogen atoms.

The term “heteroatom” means one or more of oxygen, sulfur, nitrogen, phosphorus, or silicon (including, any oxidized form of nitrogen, sulfur, phosphorus, or silicon; the quaternized form of any basic nitrogen or; a substitutable nitrogen of a heterocyclic ring, for example N (as in 3,4-dihydro-2H-pyrrolyl), NH (as in pyrrolidinyl) or NR⁺ (as in N-substituted pyrrolidinyl)).

The term “unsaturated,” as used herein, means that a moiety has one or more units of unsaturation.

As used herein, the term “bivalent C₁₋₈ (or C₁₋₆) saturated or unsaturated, straight or branched, hydrocarbon chain” refers to bivalent alkylene, alkenylene, and alkynylene chains that are straight or branched as defined herein.

The term “alkylene” refers to a bivalent alkyl group. An “alkylene chain” is a polymethylene group, i.e., —(CH₂)_(n)—, wherein n is a positive integer, preferably from 1 to 6, from 1 to 4, from 1 to 3, from 1 to 2, or from 2 to 3. A substituted alkylene chain is a polymethylene group in which one or more methylene hydrogen atoms are replaced with a substituent. Suitable substituents include those described below for a substituted aliphatic group.

The term “alkenylene” refers to a bivalent alkenyl group. A substituted alkenylene chain is a polymethylene group containing at least one double bond in which one or more hydrogen atoms are replaced with a substituent. Suitable substituents include those described below for a substituted aliphatic group.

The term “halogen” means F, Cl, Br, or I.

The term “aryl” used alone or as part of a larger moiety as in “aralkyl,” “aralkoxy,” or “aryloxyalkyl,” refers to monocyclic or bicyclic ring systems having a total of five to fourteen ring members, wherein at least one ring in the system is aromatic and wherein each ring in the system contains 3 to 7 ring members. The term “aryl” may be used interchangeably with the term “aryl ring.” In certain embodiments of the present invention, “aryl” refers to an aromatic ring system which includes, but not limited to, phenyl, biphenyl, naphthyl, anthracyl and the like, which may bear one or more substituents. Also included within the scope of the term “aryl,” as it is used herein, is a group in which an aromatic ring is fused to one or more non-aromatic rings, such as indanyl, phthalimidyl, naphthimidyl, phenanthridinyl, or tetrahydronaphthyl, and the like.

The terms “heteroaryl” and “heteroar-,” used alone or as part of a larger moiety, e.g., “heteroaralkyl,” or “heteroaralkoxy,” refer to groups having 5 to 10 ring atoms, preferably 5, 6, or 9 ring atoms; having 6, 10, or 14 π electrons shared in a cyclic array; and having, in addition to carbon atoms, from one to five heteroatoms. The term “heteroatom” refers to nitrogen, oxygen, or sulfur, and includes any oxidized form of nitrogen or sulfur, and any quaternized form of a basic nitrogen. Heteroaryl groups include, without limitation, thienyl, furanyl, pyrrolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, oxazolyl, isoxazolyl, oxadiazolyl, thiazolyl, isothiazolyl, thiadiazolyl, pyridyl, pyridazinyl, pyrimidinyl, pyrazinyl, indolizinyl, purinyl, naphthyridinyl, and pteridinyl. The terms “heteroaryl” and “heteroar-”, as used herein, also include groups in which a heteroaromatic ring is fused to one or more aryl, cycloaliphatic, or heterocyclyl rings, where the radical or point of attachment is on the heteroaromatic ring. Nonlimiting examples include indolyl, isoindolyl, benzothienyl, benzofuranyl, dibenzofuranyl, indazolyl, benzimidazolyl, benzthiazolyl, quinolyl, isoquinolyl, cinnolinyl, phthalazinyl, quinazolinyl, quinoxalinyl, 4H-quinolizinyl, carbazolyl, acridinyl, phenazinyl, phenothiazinyl, phenoxazinyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl, and pyrido[2,3-b]-1,4-oxazin-3(4H)-one. A heteroaryl group may be mono- or bicyclic. The term “heteroaryl” may be used interchangeably with the terms “heteroaryl ring,” “heteroaryl group,” or “heteroaromatic,” any of which terms include rings that are optionally substituted. The term “heteroaralkyl” refers to an alkyl group substituted by a heteroaryl, wherein the alkyl and heteroaryl portions independently are optionally substituted.

As used herein, the terms “heterocycle,” “heterocyclyl,” “heterocyclic radical,” and “heterocyclic ring” are used interchangeably and refer to a stable 5- to 7-membered monocyclic or 7-10-membered bicyclic heterocyclic moiety that is either saturated or partially unsaturated, and having, in addition to carbon atoms, one or more, preferably one to four, heteroatoms, as defined above. When used in reference to a ring atom of a heterocycle, the term “nitrogen” includes a substituted nitrogen. As an example, in a saturated or partially unsaturated ring having 0-3 heteroatoms selected from oxygen, sulfur or nitrogen, the nitrogen may be N (as in 3,4-dihydro-2H-pyrrolyl), NH (as in pyrrolidinyl), or +NR (as in N-substituted pyrrolidinyl).

A heterocyclic ring can be attached to its pendant group at any heteroatom or carbon atom that results in a stable structure and any of the ring atoms can be optionally substituted. Examples of such saturated or partially unsaturated heterocyclic radicals include, without limitation, tetrahydrofuranyl, tetrahydrothiophenyl, pyrrolidinyl, piperidinyl, pyrrolinyl, tetrahydroquinolinyl, tetrahydroisoquinolinyl, decahydroquinolinyl, oxazolidinyl, piperazinyl, dioxanyl, dioxolanyl, di azepinyl, oxazepinyl, thiazepinyl, morpholinyl, and quinuclidinyl. The terms “heterocycle,” “heterocyclyl,” “heterocyclyl ring,” “heterocyclic group,” “heterocyclic moiety,” and “heterocyclic radical,” are used interchangeably herein, and also include groups in which a heterocyclyl ring is fused to one or more aryl, heteroaryl, or cycloaliphatic rings, such as indolinyl, 3H-indolyl, chromanyl, phenanthridinyl, or tetrahydroquinolinyl. A heterocyclyl group may be mono- or bicyclic. The term “heterocyclylalkyl” refers to an alkyl group substituted by a heterocyclyl, wherein the alkyl and heterocyclyl portions independently are optionally substituted.

As used herein, the term “partially unsaturated” refers to a ring moiety that includes at least one double or triple bond. The term “partially unsaturated” is intended to encompass rings having multiple sites of unsaturation, but is not intended to include aryl or heteroaryl moieties, as herein defined.

As described herein, compounds of the invention may contain “optionally substituted” moieties. In general, the term “substituted,” whether preceded by the term “optionally” or not, means that one or more hydrogens of the designated moiety are replaced with a suitable substituent. Unless otherwise indicated, an “optionally substituted” group may have a suitable substituent at each substitutable position of the group, and when more than one position in any given structure may be substituted with more than one substituent selected from a specified group, the substituent may be either the same or different at every position. Combinations of substituents envisioned by this invention are preferably those that result in the formation of stable or chemically feasible compounds. The term “stable,” as used herein, refers to compounds that are not substantially altered when subjected to conditions to allow for their production, detection, and, in certain embodiments, their recovery, purification, and use for one or more of the purposes disclosed herein.

Each optional substituent on a substitutable carbon is a monovalent substituent independently selected from halogen; —(CH₂)₀₋₄R^(∘); —(CH₂)₀₋₄OR^(∘); —O(CH₂)₀₋₄R^(∘), —O—(CH₂)₀₋₄C(O)OR^(∘); —(CH₂)₀₋₄CH(OR^(∘))₂; —(CH₂)₀₋₄SR^(∘); —(CH₂)₀₋₄Ph, which may be substituted with R^(∘); —(CH₂)₀₋₄O(CH₂)₀₋₁Ph which may be substituted with R^(∘); —CH═CHPh, which may be substituted with R^(∘); —(CH₂)₀₋₄O(CH₂)₀₋₁-pyridyl which may be substituted with R^(∘); —NO₂; —CN; —N₃; —(CH₂)₀₋₄N(R^(∘))₂; —(CH₂)₀₋₄N(R^(∘))C(O)R^(∘); —N(R^(∘))C(S)R^(∘); —(CH₂)₀₋₄N(R^(∘))C(O)NR^(∘) ₂; —N(R^(∘))C(S)NR^(∘) ₂; —(CH₂)₀₋₄N(R^(∘))C(O)OR^(∘); —N(R^(∘))N(R^(∘))C(O)R^(∘); —N(R^(∘))N(R^(∘))C(O)NR^(∘) ₂; —N(R^(∘))N(R^(∘))C(O)OR^(∘); —(CH₂)₀₋₄C(O)R^(∘); —C(S)R^(∘); —(CH₂)₀₋₄C(O)OR^(∘); —(CH₂)₀₋₄C(O)SR^(∘); —(CH₂)₀₋₄C(O)OSiR^(∘)3; —(CH₂)₀₋₄OC(O)R^(∘); —OC(O)(CH₂)₀₋₄SR—, SC(S)SR^(∘); —(CH₂)₀₋₄SC(O)R^(∘); —(CH₂)₀₋₄C(O)NR⁰²; —C(S)NR^(∘) ₂; —C(S)SR^(∘); —SC(S)SR^(∘), —(CH₂)₀₋₄OC(O)NR^(∘) ₂; —C(O)N(OR^(∘))R^(∘); —C(O)C(O)R^(∘); —C(O)CH₂C(O)R^(∘); —C(NOR^(∘))R^(∘); —(CH₂)₀₋₄SSR^(∘); —(CH₂)₀₋₄S(O)₂R^(∘); —(CH₂)₀₋₄S(O)₂OR^(∘); —(CH₂)₀₋₄OS(O)₂R^(∘); —S(O)₂NR^(∘) ₂; —S(O)(NR^(∘))R^(∘); —S(O)₂N═C(NR^(∘) ₂)₂; —(CH₂)₀₋₄S(O)R^(∘); —N(R^(∘))S(O)₂NR^(∘) ₂; —N(R^(∘))S(O)₂R^(∘); —N(OR^(∘))R^(∘); —C(NH)NR^(∘) ₂; —P(O)₂R^(∘); —P(O)R^(∘) ₂; —OP(O)R^(∘) ₂; —OP(O)(OR^(∘))₂; SiR^(∘) ₃; —(C₁₋₄ straight or branched alkylene)O—N(R^(∘))₂; or —(C₁₋₄ straight or branched alkylene)C(O)O—N(R^(∘))₂.

Each R^(∘) is independently hydrogen, C₁₋₆ aliphatic, —CH₂Ph, —O(CH₂)₀₋₁Ph, —CH₂-(5-6 membered heteroaryl ring), or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or, notwithstanding the definition above, two independent occurrences of R^(∘), taken together with their intervening atom(s), form a 3-12-membered saturated, partially unsaturated, or aryl mono- or bicyclic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, which may be substituted by a divalent substituent on a saturated carbon atom of R^(∘) selected from ═O and ═S; or each R^(∘) is optionally substituted with a monovalent substituent independently selected from halogen, —(CH₂)₀₋₂R^(•), -(haloR^(•)), —(CH₂)₀₋₂OH, —(CH₂)₀₋₂OR^(•), —(CH₂)₀₋₂CH(OR^(•))₂; —O(haloR^(•)), —CN, —N₃, —(CH₂)₀₋₂C(O)R^(•), —(CH₂)₀₋₂C(O)OH, —(CH₂)₀₋₂C(O)OR^(•), —(CH₂)₀₋₂SR^(•), —(CH₂)₀₋₂SH, —(CH₂)₀₋₂NH₂, —(CH₂)₀₋₂NHR^(•), —(CH₂)₀₋₂NR^(•) ₂, —NO₂, —SiR^(•) ₃, —OSiR^(•) ₃, —C(O)SR^(•), —(C₁₋₄ straight or branched alkylene)C(O)OR^(•), or—SSR^(•).

Each R^(•) is independently selected from C₁₋₄ aliphatic, —CH₂Ph, —O(CH₂)₀₋₁Ph, or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, and wherein each R^(•) is unsubstituted or where preceded by halo is substituted only with one or more halogens; or wherein an optional substituent on a saturated carbon is a divalent substituent independently selected from ═O, ═S, ═NNR*₂, ═NNHC(O)R*, ═NNHC(O)OR*, ═NNHS(O)₂R*, ═NR*, ═NOR*, —O(C(R*₂))₂₋₃O—, or —S(C(R*₂))₂₋₃S—, or a divalent substituent bound to vicinal substitutable carbons of an “optionally substituted” group is —O(CR*₂)₂₋₃O—, wherein each independent occurrence of R* is selected from hydrogen, C₁₋₆ aliphatic or an unsubstituted 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

When R* is C₁₋₆ aliphatic, R* is optionally substituted with halogen, —R^(•), -(haloR^(•)), —OH, —OR^(•), —O(haloR^(•)), —CN, —C(O)OH, —C(O)OR^(•), —NH₂, —NHR^(•), —NR^(•) ₂, or —NO₂, wherein each R^(•) is independently selected from C₁₋₄ aliphatic, —CH₂Ph, —O(CH₂)₀₋₁Ph, or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, and wherein each R^(•) is unsubstituted or where preceded by halo is substituted only with one or more halogens.

An optional substituent on a substitutable nitrogen is independently —R^(†), —NR^(†) ₂, —C(O)R^(†), —C(O)OR^(†), —C(O)C(O)R^(†), —C(O)CH₂C(O)R^(†), —S(O)₂R^(†), —S(O)₂NR^(†) ₂, —C(S)NR^(†) ₂, —C(NH)NR^(†) ₂, or —N(R^(†))S(O)₂R^(†); wherein each R is independently hydrogen, C₁₋₆ aliphatic, unsubstituted —OPh, or an unsubstituted 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or, two independent occurrences of R^(†), taken together with their intervening atom(s) form an unsubstituted 3-12-membered saturated, partially unsaturated, or aryl mono- or bicyclic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur; wherein when R is C₁₋₆ aliphatic, R is optionally substituted with halogen, —R^(•), -(haloR^(•)), —OH, —OR^(•), —O(haloR^(•)), —CN, —C(O)OH, —C(O)OR^(•), —NH₂, —NHR^(•), —NR^(•) ₂, or —NO₂, wherein each R^(•) is independently selected from C₁_₄ aliphatic, —CH₂Ph, —O(CH₂)₀₋₁Ph, or a 5-6-membered saturated, partially unsaturated, or aryl ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, and wherein each R^(•) is unsubstituted or where preceded by halo is substituted only with one or more halogens.

As used herein, the term “pharmaceutically acceptable salt” refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio. Pharmaceutically acceptable salts are well known in the art. For example, S. M. Berge et al., describe pharmaceutically acceptable salts in detail in J. Pharmaceutical Sciences, 1977, 66, 1-19, incorporated herein by reference. Pharmaceutically acceptable salts of the compounds of this invention include those derived from suitable inorganic and organic acids and bases. Examples of pharmaceutically acceptable, nontoxic acid addition salts include salts of an amino group (or other basic group) formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid, and perchloric acid or with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid, or malonic acid, or by using other methods used in the art such as ion exchange. Other pharmaceutically acceptable salts include adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, besylate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2-hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pectinate, persulfate, 3-phenylpropionate, phosphate, pivalate, propionate, stearate, succinate, sulfate, tartrate, thiocyanate, p-toluenesulfonate, undecanoate, valerate salts, and the like.

Salts derived from appropriate bases include alkali metal, alkaline earth metal, ammonium and N⁺(C₁₋₄ alkyl)₄ salts. Representative alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like. Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, loweralkyl sulfonate and aryl sulfonate.

Unless otherwise stated, structures depicted herein are also meant to include all isomeric (e.g., enantiomeric, diastereomeric, and geometric (or conformational)) forms of the structure; for example, the R and S configurations for each asymmetric center, Z and E double bond isomers, and Z and E conformational isomers. Therefore, single stereochemical isomers as well as enantiomeric, diastereomeric, and geometric (or conformational) mixtures of the present compounds are within the scope of the invention. Unless otherwise stated, all tautomeric forms of the compounds of the invention are within the scope of the invention. Additionally, unless otherwise stated, structures depicted herein are also meant to include compounds that differ only in the presence of one or more isotopically enriched atoms. For example, compounds having the present structures including the replacement of hydrogen by deuterium or tritium, or the replacement of a carbon by a ¹³C- or ¹⁴C-enriched carbon are within the scope of this invention. Such compounds are useful, for example, as analytical tools, as probes in biological assays, or as therapeutic agents in accordance with the present invention.

3. Uses, Formulation and Administration Uses of Lymphatic-Directing Lipid Prodrugs

Disclosed lymphatic-directing lipid prodrugs, as well as pharmaceutically acceptable compositions comprising a disclosed lipid prodrug, and a pharmaceutically acceptable excipient, diluent, or carrier, are useful for treating a variety of diseases, disorders or conditions. Such diseases, disorders, or conditions include those described herein.

One of ordinary skill in the art will recognize and appreciate that each of the therapeutic agents described herein are known to be associated with treatment of one or more diseases, disorders, or conditions. Accordingly, it will be appreciated that, in certain embodiments, the present invention provides a method of treating a disease, disorder, or condition in a patient in need thereof comprising administering to said patient a disclosed lipid prodrug.

The presently disclosed lipid prodrugs are useful for the stable transport of pharmaceutical agents to the intestinal lymph and release of the pharmaceutical agents in the lymph, lymphocytes, lymphoid tissues, tissues with high lipase activity such as adipose tissue, certain cancers, the liver, or in the systemic circulation. Disclosed lipid prodrugs are particularity useful for the transport and release of pharmaceutical agents that benefit from avoidance of first pass metabolism, for example, therapeutic agents that exhibit greater than about 50% first pass metabolism when administered orally. In some embodiments, the therapeutic agent exhibits greater than about 60% first pass metabolism when administered orally. In some embodiments, the therapeutic agent exhibits greater than about 70%, 80%, or 90% first pass metabolism when administered orally.

The presently disclosed lipid prodrugs are also useful for the targeted release of the therapeutic agent within the lymphatic system, for example, in the lymph, lymphocytes and lymphoid tissues, as well as in tissues with high lipase activity such as adipose tissue, certain cancers, or the liver. In some embodiments, the therapeutic agent exhibits poor lymphatic transport when administered orally. In some embodiments, the therapeutic exhibits less than 70%, 60%, 50%, 40%, 30%, 20%, 15%, 10%, 8%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.25%, 0.2%, 0.15%, or 0.1% lymphatic transport when administered orally. In contrast, the present invention provides for improved lymphatic transport of such therapeutic agents. In some embodiments, a disclosed lipid prodrug exhibits at least 1%, 5%, 7.5%, 10%, 12.5%, 15%, 20%, 25%, 30%, 35%, 40%, or 50% lymphatic transport when administered orally. In some embodiments, a disclosed lipid prodrug exhibits about 1-50%, 5-40%, 10-30%, 15-25%, or about 50%, 40%, 30%, 25%, 20%, 15%, 12.5%, 10%, 7.5%, 5%, 2.5%, or 1% lymphatic transport when administered orally, as measured by either w/w % of the lipid prodrug administered or w/w % of the therapeutic agent in its lipid prodrug form vs. the unmodified therapeutic agent.

In some embodiments, a disclosed lipid prodrug is delivered to the central nervous system (CNS) or crosses the blood-brain barrier (BBB) via the lymphatic system.

In some embodiments, the present invention provides a method of modulating an immune response, comprising administering to a patient in need thereof an effective amount of a disclosed lipid prodrug that comprises an immunomodulatory therapeutic agent. In some embodiments, the immune response includes one or more immune responses mediated by the lymphatic system, or mediated by immune cells in the lymphatic system. In some embodiments, the patient is suffering from a hyperproliferative disease, disorder, or condition such as cancer. In some embodiments, the patient is suffering from an autoimmune disease, disorder, or condition. In certain embodiments, the disease, disorder, or condition is any of those listed in any of Tables 1 through 7.

Therapeutic agents that may benefit from the stable transport to the intestinal lymph and release in the lymph, lymphocytes, lymphoid tissues, tissues with high lipase activity such as adipose tissue, certain cancers, the liver or in the systemic circulation include, but are not limited to, testosterone, mycophenolic acid, oestrogens (estrogen), morphine, tetrahydrocannabinol, cannabidiol, metoprolol, raloxifene, alphaxolone, statins such as atorvastatin, pentazocine, propranolol, L-DOPA, buprenorphine, midazolam, lidocaine, chlorpromazine, amitriptyline, nortriptyline, pentazocine, isosorbidedinitrate, glyceryl trinitrate, oxprenolol, labetalol, verapamil, salbutamol, epitiostanol, melphalan, and lovastatin.

Pharmaceutically Acceptable Compositions

According to another embodiment, the present invention provides a composition comprising a lipid prodrug of the present disclosure and a pharmaceutically acceptable carrier, adjuvant, or vehicle. The amount of lipid prodrug in the composition is an amount effective to treat the relevant disease, disorder, or condition in a patient in need thereof (an “effective amount”). In some embodiments, a composition of the present disclosure is formulated for oral administration to a patient.

The term “patient,” as used herein, means an animal, for example a mammal, such as a human.

The term “pharmaceutically acceptable carrier, adjuvant, or vehicle” refers to a non-toxic carrier, adjuvant, or vehicle that does not destroy the pharmacological activity of the agent with which it is formulated. Pharmaceutically acceptable carriers, adjuvants or vehicles that may be used in the disclosed compositions include, but are not limited to, ion exchangers, alumina, stearates such as aluminum stearate, lecithin, serum proteins such as human serum albumin, buffer substances such as phosphates, glycine, sorbic acid, potassium sorbate, partial glyceride mixtures of saturated vegetable fatty acids, water, salts or electrolytes, such as protamine sulfate, disodium hydrogen phosphate, potassium hydrogen phosphate, sodium chloride, zinc salts, colloidal silica, magnesium trisilicate, polyvinyl pyrrolidone, cellulose-based substances, polyethylene glycol, sodium carboxymethylcellulose, polyacrylates, waxes, polyethylene-polyoxypropylene-block polymers, polyethylene glycol and wool fat. In some embodiments, the composition is formulated as a lipophilic mixture, such as a lipid-based composition.

Compositions of the present invention may be administered orally, parenterally, enterally, intracisternally, intraperitoneally, by inhalation spray, topically, rectally, nasally, buccally, vaginally or via an implanted reservoir. The term “parenteral” as used herein includes subcutaneous, intravenous, intramuscular, intra-articular, intra-synovial, intrasternal, intrathecal, intrahepatic, intralesional and intracranial injection or infusion techniques. In some embodiments, the composition is administered orally, intraperitoneally, or intravenously. In some embodiments, the composition is a transmucosal formulation. In some embodiments, the composition is injected directly into the lymphatic system. Sterile injectable forms of the compositions of this invention may be aqueous or oleaginous suspension. These suspensions may be formulated according to techniques known in the art using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally acceptable diluent or solvent, for example as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium.

To aid in delivery of the composition, any bland fixed oil may be employed including synthetic mono- or di-glycerides. Fatty acids, such as oleic acid and its glyceride derivatives are useful in the preparation of injectables, as are natural pharmaceutically-acceptable oils, such as olive oil or castor oil, especially in their polyoxyethylated versions. These oil solutions or suspensions may also contain a long-chain alcohol diluent or dispersant, such as carboxymethyl cellulose or similar dispersing agents that are commonly used in the formulation of pharmaceutically acceptable dosage forms including emulsions and suspensions. Other commonly used surfactants, such as Tweens, Spans and other emulsifying agents or bioavailability enhancers which are commonly used in the manufacture of pharmaceutically acceptable solid, liquid, or other dosage forms may also be used for the purposes of formulation.

Pharmaceutically acceptable compositions may be orally administered in any orally acceptable dosage form including, but not limited to, capsules, tablets, aqueous suspensions or solutions. In the case of tablets for oral use, carriers commonly used include lactose and corn starch. Lubricating agents, such as magnesium stearate, may also be added. For oral administration in a capsule form, useful diluents include lactose and dried corn starch. When aqueous suspensions are required for oral use, the active ingredient is combined with emulsifying and suspending agents. If desired, certain sweetening, flavoring or coloring agents may also be added.

Alternatively, pharmaceutically acceptable compositions may be administered in the form of suppositories for rectal administration. These can be prepared by mixing the agent with a suitable non-irritating excipient that is solid at room temperature but liquid at rectal temperature and therefore will melt in the rectum to release the drug. Such materials include cocoa butter, beeswax and polyethylene glycols.

In some embodiments, the pharmaceutically acceptable composition is formulated for oral administration. Such formulations may be administered with or without food. In some embodiments, the pharmaceutically acceptable composition is administered without food. In other embodiments, the pharmaceutically acceptable composition is administered with food.

It should also be understood that a specific dosage and treatment regimen for any particular patient will depend upon a variety of factors, including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, rate of excretion, drug combination, and the judgment of the treating physician and the severity of the particular disease being treated.

Liquid dosage forms for oral administration include, but are not limited to, pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs. In addition to the active compounds, the liquid dosage forms may contain inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof. Besides inert diluents, the oral compositions can also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring, and perfuming agents.

Injectable preparations, for example, sterile injectable aqueous or oleaginous suspensions may be formulated according to the known art using suitable dispersing or wetting agents and suspending agents. The sterile injectable preparation may also be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution, U.S.P. and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil can be employed including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid are used in the preparation of injectables.

Injectable formulations can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.

In order to prolong the effect of a compound of the present invention, it is often desirable to slow the absorption of the compound from subcutaneous or intramuscular injection. This may be accomplished by the use of a liquid suspension of crystalline or amorphous material with poor water solubility. The rate of absorption of the compound then depends upon its rate of dissolution that, in turn, may depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally administered compound form is accomplished by dissolving or suspending the compound in an oil vehicle. Injectable depot forms are made by forming microencapsule matrices of the compound in biodegradable polymers such as polylactide-polyglycolide. Depending upon the ratio of compound to polymer and the nature of the particular polymer employed, the rate of compound release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly(anhydrides). Depot injectable formulations are also prepared by entrapping the compound in liposomes or microemulsions that are compatible with body tissues.

Compositions for rectal or vaginal administration are preferably suppositories which can be prepared by mixing the compounds of this invention with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at ambient temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.

Solid dosage forms for oral administration include capsules, tablets, pills, powders, and granules. In such solid dosage forms, the active compound is mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form may also comprise buffering agents.

Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like. The solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions that can be used include polymeric substances and waxes. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polethylene glycols and the like.

Therapeutic agents can also be in micro-encapsulated form with one or more excipients as noted above. The solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings, release controlling coatings and other coatings well known in the pharmaceutical formulating art. In such solid dosage forms the active compound may be admixed with at least one inert diluent such as sucrose, lactose or starch. Such dosage forms may also comprise, as is normal practice, additional substances other than inert diluents, e.g., tableting lubricants and other tableting aids such a magnesium stearate and microcrystalline cellulose. In the case of capsules, tablets and pills, the dosage forms may also comprise buffering agents. They may optionally contain opacifying agents and can also be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions that can be used include polymeric substances and waxes.

Dosage forms for topical or transdermal administration of a compound of this invention include ointments, pastes, creams, lotions, gels, powders, solutions, sprays, inhalants or patches. The active component is admixed under sterile conditions with a pharmaceutically acceptable carrier and any needed preservatives or buffers as may be required. Ophthalmic formulation, ear drops, and eye drops are also contemplated as being within the scope of this invention. Additionally, the present invention contemplates the use of transdermal patches, which have the added advantage of providing controlled delivery of a compound to the body. Such dosage forms can be made by dissolving or dispensing the compound in the proper medium. Absorption enhancers can also be used to increase the flux of the compound across the skin. The rate can be controlled by either providing a rate controlling membrane or by dispersing the compound in a polymer matrix or gel.

In some embodiments, the lipid prodrug is formulated as an orally administerable, lipid-based formulation. Lipid-based formulations for oral delivery are known in the art and may include, for example, substantially non-aqueous vehicles which typically contain one or more lipid components. The lipid vehicles and resulting lipid formulations may be usefully classified as described below according to their shared common features according to the lipid formulation classification system (LFCS) (Pouton, C. W., Eur. J. Pharm. Sci. 11 (Supp 2), S93-S98, 2000; Pouton, C. W., Eur. J. Pharm. Sci. 29 278-287, 2006).

Lipid vehicles, and the resulting lipid formulations, may contain oil/lipids and/or surfactants, optionally with co-solvents. In the LFCS terminology, Type I formulations include oils or lipids which require digestion, such as mono, di and tri-glycerides and combinations thereof. Type II formulations are water-insoluble self emulsifying drug delivery systems (SEDDS) which contain lipids and oils used in Type I formulations, with additional water insoluble surfactants. Type III formulations are SEDDS or self-microemulsifying drug delivery systems (SMEDDS) which contain lipids and oils used in Type I formulations, with additional water-soluble surfactants and/or co-solvents (Type Ma) or a greater proportion of water-soluble components (Type IIIb). Type IV formulations contain predominantly hydrophilic surfactants and co-solvents (e.g. PEG, propylene glycol and diethylene glycol monoethyl ether) and are useful for drugs which are poorly water soluble but not lipophilic. Any such lipid formulation (Type I-IV) is contemplated herein for use with a disclosed lipid prodrug or pharmaceutical composition thereof.

In some embodiments, the lipid vehicle contains one or more oils or lipids, without additional surfactants, co-surfactants or co-emulsifiers, or co-solvents, i.e. it consists essentially of one or more oils or lipids. In some further embodiments, the lipid vehicle contains one or more oils or lipids together with one or more water-insoluble surfactants, optionally together with one or more co-solvents. In some embodiments, the lipid vehicle contains one or more oils or lipids together with one or more water-soluble surfactants, optionally together with one or more co-solvents. In some embodiments, the lipid vehicle contains a mixture of oil/lipid, surfactant and co-solvent. In some embodiments, the lipid vehicle consists essentially of one or more surfactants/co-surfactants/co-emulsifiers, and/or solvents/co-solvents.

Examples of oils or lipids which may be used in the present invention include almond oil, babassu oil, blackcurrant seed oil, borage oil, canola oil, castor oil, coconut oil, cod liver oil, corn oil, cottonseed oil, evening primrose oil, fish oil, grape seed oil, mustard seed oil, olive oil, palm kernel oil, palm oil, peanut oil, rapeseed oil, safflower oil, sesame oil, shark liver oil, soybean oil, sunflower oil, walnut oil, wheat germ oil, avocado oil, bran oil, hydrogenated castor oil, hydrogenated coconut oil, hydrogenated cottonseed oil, hydrogenated palm oil, hydrogenated soybean oil, partially hydrogenated soybean oil, hydrogenated vegetable oil, caprylic/capric glycerides, fractionated triglycerides, glyceryl tricaprate, glyceryl tricaproate, glyceryl tricaprylate, glyceryl tricaprylate/caprate, glyceryl tricaprylate/caprate, glyceryl tricaprylate/caprate/laurate, glyceryl tricaprylate/caprate/linoleate, glyceryl tricaprylate/caprate/stearate, glyceryl trilaurate, glyceryl monolaurate, glyceryl behenate, glyceryl monolinoleate, glyceryl trilinolenate, glyceryl trioleate, glyceryl triundecanoate, glyceryl tristearate linoleic glycerides, saturated polyglycolized glycerides, synthetic medium chain triglycerides containing primarily C₈₋₁₂ fatty acid chains, medium chain triglycerides containing primarily C₈₋₁₂ fatty acid chains, long chain triglycerides containing primarily >C₁₂ fatty acid chains, modified triglycerides, fractionated triglycerides, and mixtures thereof.

Examples of mono and diglycerides which may be used in such formulations include glycerol mono- and diesters having fatty acid chains from 8 to 40 carbon atoms, including hydrolysed coconut oils (e.g. Capmul® MCM), hydrolysed corn oil (e.g. Maisine™35-1). In some embodiments, the monoglycerides and diglycerides are mono- or di-saturated fatty acid esters of glycerol having fatty acid chains of 8 to 18 carbon chain length (e.g. glyceryl monostearate, glyceryl distearate, glyceryl monocaprylate, glyceryl dicaprylate, glyceryl monocaprate and glyceryl dicaprate). Mixtures of fatty acids (“structured glycerides”) adapted for enhancing the absorption and transport of lipid soluble compounds are disclosed in, e.g., U.S. Pat. No. 6,013,665, which is hereby incorporated by reference.

Suitable surfactants for use in the lipid formulations include propylene glycol mono- and di-esters of C₈₋₂₂ fatty acids, such as, but not limited to, propylene glycol monocaprylate, propylene glycol dicaprylate, propylene glycol monolaurate, sold under trade names such as Capryol® 90, Labrafac® PG, Lauroglycol® FCC, sugar fatty acid esters, such as, but not limited to, sucrose palmitate, sucrose laurate, and sucrose stearate; sorbitan fatty acid esters such as, but not limited to, sorbitan laurate, sorbitan palmitate, and sorbitan oleate; polyoxyethylene sorbitan fatty acid esters such as, but not limited to, polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80, and polysorbate 85; polyoxyethylene mono- and di-fatty acid esters including, but not limited to, polyoxyl 40 stearate and polyoxyl 40 oleate; a mixture of polyoxyethylene mono- and di-esters of C₈₋₂₂ fatty acids and glyceryl mono-, di-, and tri-esters of C₈₋₂₂ fatty acids as sold under tradenames such as Labrasol®, Gelucire® 44/14, Gelucire® 50/13, and Labrafil®; polyoxyethylene castor oils compound such as, but not limited to, polyoxyl 35 castor oil, polyoxyl 40 hydrogenated castor oil, and polyoxyl 60 hydrogenated castor oil, as are sold under tradenames such as Cremophor®/Kolliphor EL, Cremophor®/Kolliphor® RH40, and Cremophor®/Kolliphor® RH60; polyoxyethylene alkyl ethers including, but not limited to, polyoxyl 20 cetostearyl ether and polyoxyl 10 oleyl ether; DL-α-tocopheryl polyethylene glycol succinate; glyceryl mono-, di-, and tri-esters; glyceryl mono-, di-, and tri-esters of C₈₋₂₂ fatty acids; sucrose mono-, di-, and tri-esters; sodium dioctylsulfosuccinate; polyoxyethylene-polyoxypropylene copolymers such as, but not limited to poloxamer 124, poloxamer 188, and poloxamer 407; polyoxyethylene ethers of C₈₋₂₂ fatty alcohols including, but not limited to, polyoxyethylenelauryl alcohol, polyoxyethylenecetyl alcohol, polyoxyethylene stearyl alcohol, polyoxyethyleneoleyl alcohol, as sold under tradenames such as Brij® 35, Brij® 58, Brij® 78, Brij® 98, or a mixture of any two or more thereof.

A co-emulsifier, or co-surfactant, may be used in the formulation. A suitable co-emulsifier or co-surfactant may be a phosphoglyceride; a phospholipid, for example lecithin, or a free fatty acid that is liquid at room temperature, for example, iso-stearic acid, oleic acid, linoelic acid, linolenic acid, palmitic acid, stearic acid, lauric acid, capric acid, caprylic acid, and caproic acid.

Suitable solvents/co-solvents include ethanol, propylene glycol, polyethylene glycol, diethylene glycol monoethyl ether, and glycerol.

A polymer may also be used in the formulation to inhibit drug precipitation or to alter the rate of drug release. A range of polymers have been shown to impart these properties and are well known to those skilled in the art. Suitable polymers include hydroxypropylmethylcellulose, hydroxypropylmethylcellulose acetyl succinate, other cellulose-derived polymers such as methylcellulose; poly(meth)acrylates, such as the Eudragit series of polymers, including Eudragit E100, polyvinylpyrrolidone, or others as described in, e.g. Warren et al., Mol. Pharmaceutics 2013, 10, 2823-2848.

Formulations may be chosen specifically to provide for sustained release of the active in the gastrointestinal (GI) tract in order to control the rate of absorption. Many different approaches may be used to achieve these ends including the use of high melting point lipids that disperse/erode slowly in the GI tract, or polymers that form a matrix that slowly erodes. These formulations may take the form of large monolithic dose forms or may be present as micro or nano-particulate matrices as described in, for example, in Mishra, Handbook of Encapsulation and Controlled Release, CRC Press, Boca Raton, (2016) ISBN 978-1-4822-3234-9, Wilson and Crowley Controlled Release in Oral Drug Delivery, Springer, NY, ISBN 978-1-4614-1004-1 (2011) or Wise, Handbook of Pharmaceutical Controlled Release Technology, Marcel Dekker, NY, ISBN 0-82467-0369-3 (2000).

Formulations may also contain materials commonly known to those skilled in the art to be included in lipid based formulations, including antioxidants, for example, butylated hydroxyanisole (BHA) or butylated hydroxytoluene (BHT) and solidifying agents such as microporous silica, for example magnesium alumino-metasilicate (Neusilin).

In some embodiments, the lipid prodrug may be co-administered orally with an enzyme inhibitor to increase stability of the prodrug in the gastrointestinal tract or enterocyte. In certain embodiments, the enzyme inhibitor inhibits pancreatic lipases, examples of which include, but are not limited to, Alli® (orlistat). In other embodiments it is envisaged that the enzyme inhibitor will inhibit cellular lipase enzymes such as monoacylglycerol lipase, an example of which includes, but is not limited to, JZL184 (4-nitrophenyl-4-[bis(1,3-benzodioxol-5-yl)(hydroxy)methyl]piperidine-1-carboxylate).

Combination Therapies

A provided lipid prodrug, or pharmaceutically acceptable composition thereof, may be administered to a patient in need thereof in combination with one or more additional therapeutic agents and/or therapeutic processes.

The lipid prodrug or pharmaceutically acceptable composition thereof can be administered alone or in combination with one or more other therapeutic compounds, possible combination therapy taking the form of fixed combinations or the administration of the lipid prodrug or composition and one or more other therapeutic compounds being staggered or given independently of one another, or the combined administration of fixed combinations and one or more other therapeutic compounds. A disclosed lipid prodrug or composition can besides or in addition be administered especially for tumor therapy in combination with chemotherapy, radiotherapy, immunotherapy, phototherapy, surgical intervention, or a combination of these. Long-term therapy is equally possible as is adjuvant therapy in the context of other treatment strategies, as described above. Other possible treatments are therapy to maintain the patient's status after tumor regression, or even chemopreventive therapy, for example in patients at risk.

Such additional agents may be administered separately from a provided lipid prodrug or composition, as part of a multiple dosage regimen. Alternatively, those agents may be part of a single dosage form, mixed together with a disclosed lipid prodrug in a single composition. If administered as part of a multiple dosage regime, the two active agents may be submitted simultaneously, sequentially or within a period of time from one another.

As used herein, the term “combination,” “combined,” and related terms refers to the simultaneous or sequential administration of therapeutic agents in accordance with the present disclosure. For example, a disclosed lipid prodrug may be administered with another therapeutic agent simultaneously or sequentially in separate unit dosage forms or together in a single unit dosage form. Accordingly, the present disclosure provides a single unit dosage form comprising a disclosed lipid prodrug, an additional therapeutic agent, and a pharmaceutically acceptable carrier, adjuvant, or vehicle. In some embodiments, the additional agent is formulated in a separate composition from the lipid prodrug.

The amount of both a disclosed lipid prodrug and additional therapeutic agent (in those compositions which comprise an additional therapeutic agent as described above) that may be combined with the carrier materials to produce a single dosage form will vary depending upon the patient treated and the particular mode of administration. In certain embodiments, compositions of this invention should be formulated so that a dosage of between 0.01-100 mg/kg body weight/day of a disclosed lipid prodrug can be administered.

In those compositions which comprise an additional therapeutic agent, that additional therapeutic agent and the disclosed lipid prodrug may act synergistically. Therefore, the amount of additional therapeutic agent in such compositions will be less than that required in a monotherapy utilizing only that therapeutic agent. In such compositions, a dosage of between 0.01-1,000 μg/kg body weight/day of the additional therapeutic agent can be administered.

The amount of additional therapeutic agent present in the compositions of this invention will be no more than the amount that would normally be administered in a composition comprising that therapeutic agent as the only active agent. Preferably the amount of additional therapeutic agent in the presently disclosed compositions will range from about 50% to 100% of the amount normally present in a composition comprising that agent as the only therapeutically active agent.

Examples of agents with which the lipid prodrugs of this invention may be combined include, without limitation: treatments for Alzheimer's Disease such as Aricept® and Excelon®; treatments for HIV such as ritonavir; treatments for Parkinson's Disease such as L-DOPA/carbidopa, entacapone, ropinrole, pramipexole, bromocriptine, pergolide, trihexephendyl, and amantadine; agents for treating Multiple Sclerosis (MS) such as beta interferon (e.g., Avonex® and RebiC), Copaxone®, and mitoxantrone; treatments for asthma such as albuterol and Singulair®; agents for treating schizophrenia such as zyprexa, risperdal, seroquel, and haloperidol; anti-inflammatory agents such as corticosteroids, TNF blockers, IL-1 RA, azathioprine, cyclophosphamide, and sulfasalazine; immunomodulatory and immunosuppressive agents such as cyclosporin, tacrolimus, rapamycin, mycophenolate mofetil, interferons, corticosteroids, cyclophophamide, azathioprine, and sulfasalazine; neurotrophic factors such as acetylcholinesterase inhibitors, MAO inhibitors, interferons, anti-convulsants, ion channel blockers, riluzole, and anti-Parkinsonian agents; agents for treating cardiovascular disease such as beta-blockers, ACE inhibitors, diuretics, nitrates, calcium channel blockers, and statins; agents for treating liver disease such as corticosteroids, cholestyramine, interferons, and anti-viral agents; agents for treating blood disorders such as corticosteroids, anti-leukemic agents, and growth factors; agents that prolong or improve pharmacokinetics such as cytochrome P450 inhibitors (i.e., inhibitors of metabolic breakdown) and CYP3A4 inhibitors (e.g., ketokenozole and ritonavir), and agents for treating immunodeficiency disorders such as gamma globulin.

In certain embodiments, combination therapies of the present invention include a monoclonal antibody or a siRNA therapeutic.

In another embodiment, the present invention provides a method of treating an inflammatory disease, disorder or condition by administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents. Such additional therapeutic agents may be small molecules or a biologic and include, for example, acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen, etodolac (Lodine®) and celecoxib, colchicine (Colcrys®), corticosteroids such as prednisone, prednisolone, methylprednisolone, hydrocortisone, and the like, probenecid, allopurinol, febuxostat (Uloric®), sulfasalazine (Azulfidine®), antimalarials such as hydroxychloroquine (Plaquenil®) and chloroquine (Aralen®), methotrexate (Rheumatrex®), gold salts such as gold thioglucose (Solganal®), gold thiomalate (Myochrysine®) and auranofin (Ridaura®), D-penicillamine (Depen® or Cuprimine®), azathioprine (Imuran®), cyclophosphamide (Cytoxan®), chlorambucil (Leukeran®), cyclosporine (Sandimmune®), leflunomide (Arava®) and “anti-TNF” agents such as etanercept (Enbrel®), infliximab (Remicade®), golimumab (Simponi®), certolizumab pegol (Cimzia®) and adalimumab (Humira®), “anti-IL-1” agents such as anakinra (Kineret®) and rilonacept (Arcalyst®), canakinumab (Ilaris®), JAK inhibitors such as tofacitinib, antibodies such as rituximab (Rituxan®), “anti-T-cell” agents such as abatacept (Orencia®), “anti-IL-6” agents such as tocilizumab (Actemra®), diclofenac, cortisone, hyaluronic acid (Synvisc® or Hyalgan®), monoclonal antibodies such as tanezumab, anticoagulants such as heparin (Calcinparine® or Liquaemin®) and warfarin (Coumadin®), antidiarrheals such as diphenoxylate (Lomotil®) and loperamide (Imodium®), bile acid binding agents such as cholestyramine, alosetron (Lotronex®), lubiprostone (Amitiza®), laxatives such as Milk of Magnesia, polyethylene glycol (MiraLax®), Dulcolax®, Correctol® and Senokot®, anticholinergics or antispasmodics such as dicyclomine (Bentyl®), Singulair®, beta-2 agonists such as albuterol (Ventolin® HFA, Proventil® HFA), levalbuterol (Xopenex®), metaproterenol (Alupent®), pirbuterol acetate (Maxair®), terbutaline sulfate (Brethaire®), salmeterol xinafoate (Serevent®) and formoterol (Foradil®), anticholinergic agents such as ipratropium bromide (Atrovent®) and tiotropium (Spiriva®), inhaled corticosteroids such as beclomethasone dipropionate (Beclovent®, Qvar®, and Vanceril®), triamcinolone acetonide (Azmacort®), mometasone (Asthmanex®), budesonide (Pulmocort®), and flunisolide (Aerobid®), Afviar®, Symbicort®, Dulera®, cromolyn sodium (Intal®), methylxanthines such as theophylline (Theo-Dur®, Theolair®, Slo-Bid®, Uniphyl®, Theo-24®) and aminophylline, IgE antibodies such as omalizumab (Xolair®), nucleoside reverse transcriptase inhibitors such as zidovudine (Retrovir®), abacavir (Ziagen®), abacavir/lamivudine (Epzicom®), abacavir/lamivudine/zidovudine (Trizivir®), didanosine (Videx®), emtricitabine (Emtriva®), lamivudine (Epivir®), lamivudine/zidovudine (Combivir®), stavudine (Zerit®), and zalcitabine (Hivid®), non-nucleoside reverse transcriptase inhibitors such as delavirdine (Rescriptor®), efavirenz (Sustiva®), nevairapine (Viramune®) and etravirine (Intelence®), nucleotide reverse transcriptase inhibitors such as tenofovir (Viread®), protease inhibitors such as amprenavir (Agenerase®), atazanavir (Reyataz®), darunavir (Prezista®), fosamprenavir (Lexiva®), indinavir (Crixivan®), lopinavir and ritonavir (Kaletra®), nelfinavir (Viracept®), ritonavir (Norvir®), saquinavir (Fortovase® or Invirase®), and tipranavir (Aptivus®), entry inhibitors such as enfuvirtide (Fuzeon®) and maraviroc (Selzentry®), integrase inhibitors such as raltegravir (Isentress®), doxorubicin (Hydrodaunorubicin®), vincristine (Oncovin®), bortezomib (Velcade®), and dexamethasone (Decadron®) in combination with lenalidomide (Revlimid®), or any combination(s) thereof.

In another embodiment, the present invention provides a method of treating gout comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen, etodolac (Lodine®) and celecoxib, colchicine (Colcrys®), corticosteroids such as prednisone, prednisolone, methylprednisolone, hydrocortisone, and the like, probenecid, allopurinol and febuxostat (Uloric®).

In another embodiment, the present invention provides a method of treating rheumatoid arthritis comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen, etodolac (Lodine®) and celecoxib, corticosteroids such as prednisone, prednisolone, methylprednisolone, hydrocortisone, and the like, sulfasalazine (Azulfidine®), antimalarials such as hydroxychloroquine (Plaquenil®) and chloroquine (Aralen®), methotrexate (Rheumatrex®), gold salts such as gold thioglucose (Solganal®), gold thiomalate (Myochrysine®) and auranofin (Ridaura®), D-penicillamine (Depen® or Cuprimine®), azathioprine (Imuran®), cyclophosphamide (Cytoxan®), chlorambucil (Leukeran®), cyclosporine (Sandimmune®), leflunomide (Arava®) and “anti-TNF” agents such as etanercept (Enbrel®), infliximab (Remicade®), golimumab (Simponi®), certolizumab pegol (Cimzia®) and adalimumab (Humira®), “anti-IL-1” agents such as anakinra (Kineret®) and rilonacept (Arcalyst®), antibodies such as rituximab (Rituxan®), “anti-T-cell” agents such as abatacept (Orencia®) and “anti-IL-6” agents such as tocilizumab (Actemra®).

In some embodiments, the present invention provides a method of treating osteoarthritis comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen, etodolac (Lodine®) and celecoxib, diclofenac, cortisone, hyaluronic acid (Synvisc® or Hyalgan®) and monoclonal antibodies such as tanezumab.

In some embodiments, the present invention provides a method of treating lupus comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen, naproxen, etodolac (Lodine®) and celecoxib, corticosteroids such as prednisone, prednisolone, methylprednisolone, hydrocortisone, and the like, antimalarials such as hydroxychloroquine (Plaquenil®) and chloroquine (Aralen®), cyclophosphamide (Cytoxan®), methotrexate (Rheumatrex®), azathioprine (Imuran®) and anticoagulants such as heparin (Calcinparine® or Liquaemin®) and warfarin (Coumadin®).

In some embodiments, the present invention provides a method of treating inflammatory bowel disease comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from mesalamine (Asacol®) sulfasalazine (Azulfidine®), antidiarrheals such as diphenoxylate (Lomotil®) and loperamide (Imodium®), bile acid binding agents such as cholestyramine, alosetron (Lotronex®), lubiprostone (Amitiza®), laxatives such as Milk of Magnesia, polyethylene glycol (MiraLax®), Dulcolax®, Correctol® and Senokot® and anticholinergics or antispasmodics such as dicyclomine (Bentyl®), anti-TNF therapies, steroids, and antibiotics such as Flagyl or ciprofloxacin.

In some embodiments, the present invention provides a method of treating asthma comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from Singulair®, beta-2 agonists such as albuterol (Ventolin® HFA, Proventil® HFA), levalbuterol (Xopenex®), metaproterenol (Alupent®), pirbuterol acetate (Maxair®), terbutaline sulfate (Brethaire®), salmeterol xinafoate (Serevent®) and formoterol (Foradil®), anticholinergic agents such as ipratropium bromide (Atrovent®) and tiotropium (Spiriva®), inhaled corticosteroids such as prednisone, prednisolone, beclomethasone dipropionate (Beclovent®, Qvar®, and Vanceril®), triamcinolone acetonide (Azmacort®), mometasone (Asthmanex®), budesonide (Pulmocort®), flunisolide (Aerobid®), Afviar®, Symbicort®, and Dulera®, cromolyn sodium (Intal®), methylxanthines such as theophylline (Theo-Dur®, Theolair®, Slo-Bid®, Uniphyl®, Theo-24®) and aminophylline, and IgE antibodies such as omalizumab (Xolair®).

In some embodiments, the present invention provides a method of treating COPD comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from beta-2 agonists such as albuterol (Ventolin® HFA, Proventil® HFA), levalbuterol (Xopenex®), metaproterenol (Alupent®), pirbuterol acetate (Maxair®), terbutaline sulfate (Brethaire®), salmeterol xinafoate (Serevent®) and formoterol (Foradil®), anticholinergic agents such as ipratropium bromide (Atrovent®) and tiotropium (Spiriva®), methylxanthines such as theophylline (Theo-Dur®, Theolair®, Slo-Bid®, Uniphyl®, Theo-24®) and aminophylline, inhaled corticosteroids such as prednisone, prednisolone, beclomethasone dipropionate (Beclovent®, Qvar®, and Vanceril®), triamcinolone acetonide (Azmacort®), mometasone (Asthmanex®), budesonide (Pulmocort®), flunisolide (Aerobid®), Afviar®, Symbicort®, and Dulera®, and combinations thereof.

In some embodiments, the present invention provides a method of treating HIV comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from nucleoside reverse transcriptase inhibitors such as zidovudine (Retrovir®), abacavir (Ziagen®), ab acavir/lamivudine (Epzicom®), abacavir/lamivudine/zidovudine (Trizivir®), didanosine (Videx®), emtricitabine (Emtriva®), lamivudine (Epivir®), lamivudine/zidovudine (Combivir®), stavudine (Zerit®), and zalcitabine (Hivid®), non-nucleoside reverse transcriptase inhibitors such as delavirdine (Rescriptor®), efavirenz (Sustiva®), nevairapine (Viramune®) and etravirine (Intelence®), nucleotide reverse transcriptase inhibitors such as tenofovir (Viread®), protease inhibitors such as amprenavir (Agenerase®), atazanavir (Reyataz®), darunavir (Prezista®), fosamprenavir (Lexiva®), indinavir (Crixivan®), lopinavir and ritonavir (Kaletra®), nelfinavir (Viracept®), ritonavir (Norvir®), saquinavir (Fortovase® or Invirase®), and tipranavir (Aptivus®), entry inhibitors such as enfuvirtide (Fuzeon®) and maraviroc (Selzentry®), integrase inhibitors such as raltegravir (Isentress®), and combinations thereof.

In another embodiment, the present invention provides a method of treating a hematological malignancy comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from rituximab (Rituxan®), cyclophosphamide (Cytoxan®), doxorubicin (Hydrodaunorubicin®), vincristine (Oncovin®), prednisone, a hedgehog signaling inhibitor, a Bcl-2 inhibitor, a BTK inhibitor, a JAK/pan-JAK inhibitor, a TYK2 inhibitor, a PI3K inhibitor, a SYK inhibitor, and combinations thereof.

In another embodiment, the present invention provides a method of treating a solid tumor comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from rituximab (Rituxan®), cyclophosphamide (Cytoxan®), doxorubicin (Hydrodaunorubicin®), vincristine (Oncovin®), prednisone, a hedgehog signaling inhibitor, a Bcl-2 inhibitor, a BTK inhibitor, a JAK/pan-JAK inhibitor, a TYK2 inhibitor, a PI3K inhibitor, a SYK inhibitor, and combinations thereof.

In another embodiment, the present invention provides a method of treating a hematological malignancy comprising administering to a patient in need thereof a disclosed lipid prodrug and a Hedgehog (Hh) signaling pathway inhibitor. In some embodiments, the hematological malignancy is DLBCL.

In another embodiment, the present invention provides a method of treating diffuse large B-cell lymphoma (DLBCL) comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from rituximab (Rituxan®), cyclophosphamide (Cytoxan®), doxorubicin (Hydrodaunorubicin®), vincristine (Oncovin®), prednisone, a hedgehog signaling inhibitor, and combinations thereof.

In another embodiment, the present invention provides a method of treating multiple myeloma comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from bortezomib (Velcade®), and dexamethasone (Decadron®), a hedgehog signaling inhibitor, a Bcl-2 inhibitor, a BTK inhibitor, a JAK/pan-JAK inhibitor, a TYK2 inhibitor, a PI3K inhibitor, a SYK inhibitor in combination with lenalidomide (Revlimid®).

In another embodiment, the present invention provides a method of treating Waldenström's macroglobulinemia comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from chlorambucil (Leukeran®), cyclophosphamide (Cytoxan®, Neosar®), fludarabine (Fludara®), cladribine (Leustatin®), rituximab (Rituxan®), a hedgehog signaling inhibitor, a Bcl-2 inhibitor, a BTK inhibitor, a JAK/pan-JAK inhibitor, a TYK2 inhibitor, a PI3K inhibitor, and a SYK inhibitor.

In some embodiments, the present invention provides a method of treating Alzheimer's disease comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from donepezil (Aricept®), rivastigmine (Excelon®), galantamine (Razadyne®), tacrine (Cognex®), and memantine (Namenda®).

In another embodiment, the present invention provides a method of treating organ transplant rejection or graft vs. host disease comprising administering to a patient in need thereof a disclosed lipid prodrug and one or more additional therapeutic agents selected from a steroid, cyclosporin, FK506, rapamycin, a hedgehog signaling inhibitor, a Bcl-2 inhibitor, a BTK inhibitor, a JAK/pan-JAK inhibitor, a TYK2 inhibitor, a PI3K inhibitor, and a SYK inhibitor.

In another embodiment, the present invention provides a method of treating or lessening the severity of a disease comprising administering to a patient in need thereof a disclosed lipid prodrug and a BTK inhibitor, wherein the disease is selected from inflammatory bowel disease, arthritis, systemic lupus erythematosus (SLE), vasculitis, idiopathic thrombocytopenic purpura (ITP), rheumatoid arthritis, psoriatic arthritis, osteoarthritis, Still's disease, juvenile arthritis, diabetes, myasthenia gravis, Hashimoto's thyroiditis, Ord's thyroiditis, Graves' disease, autoimmune thyroiditis, Sjogren's syndrome, multiple sclerosis, systemic sclerosis, Lyme neuroborreliosis, Guillain-Barre syndrome, acute disseminated encephalomyelitis, Addison's disease, opsoclonus-myoclonus syndrome, ankylosing spondylosis, antiphospholipid antibody syndrome, aplastic anemia, autoimmune hepatitis, autoimmune gastritis, pernicious anemia, celiac disease, Goodpasture's syndrome, idiopathic thrombocytopenic purpura, optic neuritis, scleroderma, primary biliary cirrhosis, Reiter's syndrome, Takayasu's arteritis, temporal arteritis, warm autoimmune hemolytic anemia, Wegener's granulomatosis, psoriasis, alopecia universalis, Behcet's disease, chronic fatigue, dysautonomia, membranous glomerulonephropathy, endometriosis, interstitial cystitis, pemphigus vulgaris, bullous pemphigoid, neuromyotonia, scleroderma, vulvodynia, a hyperproliferative disease, rejection of transplanted organs or tissues, Acquired Immunodeficiency Syndrome (AIDS, caused by HIV), type 1 diabetes, graft versus host disease, transplantation, transfusion, anaphylaxis, allergies (e.g., allergies to plant pollens, latex, drugs, foods, insect poisons, animal hair, animal dander, dust mites, or cockroach calyx), type I hypersensitivity, allergic conjunctivitis, allergic rhinitis, and atopic dermatitis, asthma, appendicitis, atopic dermatitis, asthma, allergy, blepharitis, bronchiolitis, bronchitis, bursitis, cervicitis, cholangitis, cholecystitis, chronic graft rejection, colitis, conjunctivitis, Crohn's disease, cystitis, dacryoadenitis, dermatitis, dermatomyositis, encephalitis, endocarditis, endometritis, enteritis, enterocolitis, epicondylitis, epididymitis, fasciitis, fibrositis, gastritis, gastroenteritis, Henoch-Schonlein purpura, hepatitis, hidradenitis suppurativa, immunoglobulin A nephropathy, interstitial lung disease, laryngitis, mastitis, meningitis, myelitis myocarditis, myositis, nephritis, oophoritis, orchitis, osteitis, otitis, pancreatitis, parotitis, pericarditis, peritonitis, pharyngitis, pleuritis, phlebitis, pneumonitis, pneumonia, polymyositis, proctitis, prostatitis, pyelonephritis, rhinitis, salpingitis, sinusitis, stomatitis, synovitis, tendonitis, tonsillitis, ulcerative colitis, uveitis, vaginitis, vasculitis, or vulvitis, B-cell proliferative disorder, e.g., diffuse large B cell lymphoma, follicular lymphoma, chronic lymphocytic lymphoma, chronic lymphocytic leukemia, acute lymphocytic leukemia, B-cell prolymphocytic leukemia, lymphoplasmacyti c lymphoma/Waldenstrom macroglobulinemia, splenic marginal zone lymphoma, multiple myeloma (also known as plasma cell myeloma), non-Hodgkin's lymphoma, Hodgkin's lymphoma, plasmacytoma, extranodal marginal zone B cell lymphoma, nodal marginal zone B cell lymphoma, mantle cell lymphoma, mediastinal (thymic) large B cell lymphoma, intravascular large B cell lymphoma, primary effusion lymphoma, Burkitt lymphoma/leukemia, or lymphomatoid granulomatosis, breast cancer, prostate cancer, or cancer of the mast cells (e.g., mastocytoma, mast cell leukemia, mast cell sarcoma, systemic mastocytosis), bone cancer, colorectal cancer, pancreatic cancer, diseases of the bone and joints including, without limitation, rheumatoid arthritis, seronegative spondyloarthropathies (including ankylosing spondylitis, psoriatic arthritis and Reiter's disease), Behcet's disease, Sjogren's syndrome, systemic sclerosis, osteoporosis, bone cancer, bone metastasis, a thromboembolic disorder, (e.g., myocardial infarct, angina pectoris, reocclusion after angioplasty, restenosis after angioplasty, reocclusion after aortocoronary bypass, restenosis after aortocoronary bypass, stroke, transitory ischemia, a peripheral arterial occlusive disorder, pulmonary embolism, deep venous thrombosis), inflammatory pelvic disease, urethritis, skin sunburn, sinusitis, pneumonitis, encephalitis, meningitis, myocarditis, nephritis, osteomyelitis, myositis, hepatitis, gastritis, enteritis, dermatitis, gingivitis, appendicitis, pancreatitis, cholocystitus, agammaglobulinemia, psoriasis, allergy, Crohn's disease, irritable bowel syndrome, ulcerative colitis, Sjogren's disease, tissue graft rejection, hyperacute rejection of transplanted organs, asthma, allergic rhinitis, chronic obstructive pulmonary disease (COPD), autoimmune polyglandular disease (also known as autoimmune polyglandular syndrome), autoimmune alopecia, pernicious anemia, glomerulonephritis, dermatomyositis, multiple sclerosis, scleroderma, vasculitis, autoimmune hemolytic and thromb ocytopenic states, Goodpasture's syndrome, atherosclerosis, Addison's disease, Parkinson's disease, Alzheimer's disease, diabetes, septic shock, systemic lupus erythematosus (SLE), rheumatoid arthritis, psoriatic arthritis, juvenile arthritis, osteoarthritis, chronic idiopathic thrombocytopenic purpura, Waldenstrom macroglobulinemia, atopic dermatitis, degenerative joint disease, vitiligo, autoimmune hypopituitarism, Behcet's disease, scleraderma, mycosis fungoides, acute inflammatory responses (such as acute respiratory distress syndrome and ischemia/reperfusion injury), and Graves' disease.

In some embodiments the present invention provides a method of treating or lessening the severity of a disease comprising administering to a patient in need thereof a disclosed lipid prodrug and a Bcl-2 inhibitor, wherein the disease is an inflammatory disorder, an autoimmune disorder, a proliferative disorder, an endocrine disorder, a neurological disorder, or a disorder associated with transplantation. In some embodiments, the disorder is a proliferative disorder, lupus, or lupus nephritis. In some embodiments, the proliferative disorder is chronic lymphocytic leukemia, diffuse large B-cell lymphoma, Hodgkin's disease, small-cell lung cancer, non-small-cell lung cancer, myelodysplastic syndrome, lymphoma, a hematological neoplasm, or a solid tumor.

In another embodiment, the present invention provides a method of treating or lessening the severity of a disease comprising administering to a patient in need thereof a disclosed lipid prodrug and a PI3K inhibitor, wherein the disease is selected from a cancer, a neurodegenative disorder, an angiogenic disorder, a viral disease, an autoimmune disease, an inflammatory disorder, a hormone-related disease, conditions associated with organ transplantation, immunodeficiency disorders, a destructive bone disorder, a proliferative disorder, an infectious disease, a condition associated with cell death, thrombin-induced platelet aggregation, chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL), liver disease, pathologic immune conditions involving T cell activation, a cardiovascular disorder, and a CNS disorder.

In another embodiment, the present invention provides a method of treating or lessening the severity of a disease comprising administering to a patient in need thereof a disclosed lipid prodrug and a PI3K inhibitor, wherein the disease is selected from benign or malignant tumor, carcinoma or solid tumor of the brain, kidney (e.g., renal cell carcinoma (RCC)), liver, adrenal gland, bladder, breast, stomach, gastric tumors, ovaries, colon, rectum, prostate, pancreas, lung, vagina, endometrium, cervix, testis, genitourinary tract, esophagus, larynx, skin, bone or thyroid, sarcoma, glioblastomas, neuroblastomas, multiple myeloma or gastrointestinal cancer, especially colon carcinoma or colorectal adenoma or a tumor of the neck and head, an epidermal hyperproliferation, psoriasis, prostate hyperplasia, a neoplasia, a neoplasia of epithelial character, adenoma, adenocarcinoma, keratoacanthoma, epidermoid carcinoma, large cell carcinoma, non-small-cell lung carcinoma, lymphomas, (including, for example, non-Hodgkin's Lymphoma (NHL) and Hodgkin's lymphoma (also termed Hodgkin's or Hodgkin's disease)), a mammary carcinoma, follicular carcinoma, undifferentiated carcinoma, papillary carcinoma, seminoma, melanoma, or a leukemia, diseases include Cowden syndrome, Lhermitte-Dudos disease and Bannayan-Zonana syndrome, or diseases in which the PI3K/PKB pathway is aberrantly activated, asthma of whatever type or genesis including both intrinsic (non-allergic) asthma and extrinsic (allergic) asthma, mild asthma, moderate asthma, severe asthma, bronchitic asthma, exercise-induced asthma, occupational asthma and asthma induced following bacterial infection, acute lung injury (ALI), adult/acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary, airways or lung disease (COPD, COAD or COLD), including chronic bronchitis or dyspnea associated therewith, emphysema, as well as exacerbation of airways hyperreactivity consequent to other drug therapy, in particular other inhaled drug therapy, bronchitis of whatever type or genesis including, but not limited to, acute, arachidic, catarrhal, croupus, chronic or phthinoid bronchitis, pneumoconiosis (an inflammatory, commonly occupational, disease of the lungs, frequently accompanied by airways obstruction, whether chronic or acute, and occasioned by repeated inhalation of dusts) of whatever type or genesis, including, for example, aluminosis, anthracosis, asbestosis, chalicosis, ptilosis, siderosis, silicosis, tabacosis and byssinosis, Loffler's syndrome, eosinophilic, pneumonia, parasitic (in particular metazoan) infestation (including tropical eosinophilia), bronchopulmonary aspergillosis, polyarteritis nodosa (including Churg-Strauss syndrome), eosinophilic granuloma and eosinophil-related disorders affecting the airways occasioned by drug-reaction, psoriasis, contact dermatitis, atopic dermatitis, alopecia areata, erythema multiforma, dermatitis herpetiformis, scleroderma, vitiligo, hypersensitivity angiitis, urticaria, bullous pemphigoid, lupus erythematosus, pemphisus, epidermolysis bullosa acquisita, conjunctivitis, keratoconjunctivitis sicca, and vernal conjunctivitis, diseases affecting the nose including allergic rhinitis, and inflammatory disease in which autoimmune reactions are implicated or having an autoimmune component or etiology, including autoimmune hematological disorders (e.g. hemolytic anemia, aplastic anemia, pure red cell anemia and idiopathic thrombocytopenia), systemic lupus erythematosus, rheumatoid arthritis, polychondritis, sclerodoma, Wegener granulamatosis, dermatomyositis, chronic active hepatitis, myasthenia gravis, Steven-Johnson syndrome, idiopathic sprue, autoimmune inflammatory bowel disease (e.g. ulcerative colitis and Crohn's disease), endocrine opthalmopathy, Grave's disease, sarcoidosis, alveolitis, chronic hypersensitivity pneumonitis, multiple sclerosis, primary biliary cirrhosis, uveitis (anterior and posterior), keratoconjunctivitis sicca and vernal keratoconjunctivitis, interstitial lung fibrosis, psoriatic arthritis and glomerulonephritis (with and without nephrotic syndrome, e.g. including idiopathic nephrotic syndrome or minal change nephropathy, restenosis, cardiomegaly, atherosclerosis, myocardial infarction, ischemic stroke and congestive heart failure, Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Huntington's disease, and cerebral ischemia, and neurodegenerative disease caused by traumatic injury, glutamate neurotoxicity and hypoxia.

A disclosed lipid prodrug of the current invention may also be used to advantage in combination with an antiproliferative compound. Such antiproliferative compounds include, but are not limited to, aromatase inhibitors; antiestrogens; topoisomerase I inhibitors; topoisomerase II inhibitors; microtubule active compounds; alkylating compounds; histone deacetylase inhibitors; compounds which induce cell differentiation processes; cyclooxygenase inhibitors; MMP inhibitors; mTOR inhibitors; antineoplastic antimetabolites; platin compounds; compounds targeting/decreasing a protein or lipid kinase activity and further anti-angiogenic compounds; compounds which target, decrease or inhibit the activity of a protein or lipid phosphatase; gonadorelin agonists; anti-androgens; methionine aminopeptidase inhibitors; matrix metalloproteinase inhibitors; bisphosphonates; biological response modifiers; antiproliferative antibodies; heparanase inhibitors; inhibitors of Ras oncogenic isoforms; telomerase inhibitors; proteasome inhibitors; compounds used in the treatment of hematologic malignancies; compounds which target, decrease or inhibit the activity of Flt-3; Hsp90 inhibitors such as 17-AAG (17-allylaminogeldanamycin, NSC330507), 17-DMAG (17-dimethylaminoethylamino-17-demethoxy-geldanamycin, NSC707545), IPI-504, CNF1010, CNF2024, CNF1010 from Conforma Therapeutics; temozolomide (Temodal); kinesin spindle protein inhibitors, such as SB715992 or SB743921 from GlaxoSmithKline, or pentamidine/chlorpromazine from CombinatoRx; MEK inhibitors such as ARRY142886 from Array BioPharma, AZD6244 from AstraZeneca, PD181461 from Pfizer and leucovorin. The term “aromatase inhibitor” as used herein relates to a compound which inhibits estrogen production, for instance, the conversion of the substrates androstenedione and testosterone to estrone and estradiol, respectively. The term includes, but is not limited to steroids, especially atamestane, exemestane and formestane and, in particular, non-steroids, especially aminoglutethimide, roglethimide, pyridoglutethimide, trilostane, testolactone, ketokonazole, vorozole, fadrozole, anastrozole and letrozole. Exemestane is marketed under the trade name Aromasin™. Formestane is marketed under the trade name Lentaron™. Fadrozole is marketed under the trade name Afema™. Anastrozole is marketed under the trade name Arimidex™. Letrozole is marketed under the trade names Femara™ or Femar™ Aminoglutethimide is marketed under the trade name Orimeten™. A combination of the invention comprising a chemotherapeutic agent which is an aromatase inhibitor is particularly useful for the treatment of hormone receptor positive tumors, such as breast tumors.

The term “antiestrogen” as used herein relates to a compound which antagonizes the effect of estrogens at the estrogen receptor level. The term includes, but is not limited to tamoxifen, fulvestrant, raloxifene and raloxifene hydrochloride. Tamoxifen is marketed under the trade name Nolvadex™. Raloxifene hydrochloride is marketed under the trade name Evista™. Fulvestrant can be administered under the trade name Faslodex™. A combination of the invention comprising a chemotherapeutic agent which is an antiestrogen is particularly useful for the treatment of estrogen receptor positive tumors, such as breast tumors.

The term “anti-androgen” as used herein relates to any substance which is capable of inhibiting the biological effects of androgenic hormones and includes, but is not limited to, bicalutamide (Casodex™). The term “gonadorelin agonist” as used herein includes, but is not limited to abarelix, goserelin and goserelin acetate. Goserelin can be administered under the trade name Zoladex™.

The term “topoisomerase I inhibitor” as used herein includes, but is not limited to topotecan, gimatecan, irinotecan, camptothecian and its analogues, 9-nitrocamptothecin and the macromolecular camptothecin conjugate PNU-166148. Irinotecan can be administered, e.g. in the form as it is marketed, e.g. under the trademark Camptosar™. Topotecan is marketed under the trade name Hycamptin™.

The term “topoisomerase II inhibitor” as used herein includes, but is not limited to the anthracyclines such as doxorubicin (including liposomal formulation, such as Caelyx™) daunorubicin, epirubicin, idarubicin and nemorubicin, the anthraquinones mitoxantrone and losoxantrone, and the podophillotoxines etoposide and teniposide. Etoposide is marketed under the trade name Etopophos™. Teniposide is marketed under the trade name VM 26-Bristol Doxorubicin is marketed under the trade name Acriblastin™ or Adriamycin™. Epirubicin is marketed under the trade name Farmorubicin™. Idarubicin is marketed under the trade name Zavedos™. Mitoxantrone is marketed under the trade name Novantron.

The term “microtubule active agent” relates to microtubule stabilizing, microtubule destabilizing compounds and microtublin polymerization inhibitors including, but not limited to taxanes, such as paclitaxel and docetaxel; vinca alkaloids, such as vinblastine or vinblastine sulfate, vincristine or vincristine sulfate, and vinorelbine; discodermolides; cochicine and epothilones and derivatives thereof. Paclitaxel is marketed under the trade name Taxol™. Docetaxel is marketed under the trade name Taxotere™. Vinblastine sulfate is marketed under the trade name Vinblastin R.P™. Vincristine sulfate is marketed under the trade name Farmistin™.

The term “alkylating agent” as used herein includes, but is not limited to, cyclophosphamide, ifosfamide, melphalan or nitrosourea (BCNU or Gliadel). Cyclophosphamide is marketed under the trade name Cyclostin™. Ifosfamide is marketed under the trade name Holoxan™.

The term “histone deacetylase inhibitors” or “HDAC inhibitors” relates to compounds which inhibit the histone deacetylase and which possess antiproliferative activity. This includes, but is not limited to, suberoylanilide hydroxamic acid (SAHA).

The term “antineoplastic antimetabolite” includes, but is not limited to, 5-fluorouracil or 5-FU, capecitabine, gemcitabine, DNA demethylating compounds, such as 5-azacytidine and decitabine, methotrexate and edatrexate, and folic acid antagonists such as pemetrexed. Capecitabine is marketed under the trade name Xeloda™. Gemcitabine is marketed under the trade name Gemzar™.

The term “platin compound” as used herein includes, but is not limited to, carboplatin, cis-platin, cisplatinum and oxaliplatin. Carboplatin can be administered, e.g., in the form as it is marketed, e.g. under the trademark Carboplat™. Oxaliplatin can be administered, e.g., in the form as it is marketed, e.g. under the trademark Eloxatin™.

The term “compounds targeting/decreasing a protein or lipid kinase activity; or a protein or lipid phosphatase activity; or further anti-angiogenic compounds” as used herein includes, but is not limited to, protein tyrosine kinase and/or serine and/or threonine kinase inhibitors or lipid kinase inhibitors, such as a) compounds targeting, decreasing or inhibiting the activity of the platelet-derived growth factor-receptors (PDGFR), such as compounds which target, decrease or inhibit the activity of PDGFR, especially compounds which inhibit the PDGF receptor, such as an N-phenyl-2-pyrimidine-amine derivative, such as imatinib, SU101, SU6668 and GFB-111; b) compounds targeting, decreasing or inhibiting the activity of the fibroblast growth factor-receptors (FGFR); c) compounds targeting, decreasing or inhibiting the activity of the insulin-like growth factor receptor I (IGF-IR), such as compounds which target, decrease or inhibit the activity of IGF-IR, especially compounds which inhibit the kinase activity of IGF-I receptor, or antibodies that target the extracellular domain of IGF-I receptor or its growth factors; d) compounds targeting, decreasing or inhibiting the activity of the Trk receptor tyrosine kinase family, or ephrin B4 inhibitors; e) compounds targeting, decreasing or inhibiting the activity of the AxI receptor tyrosine kinase family; f) compounds targeting, decreasing or inhibiting the activity of the Ret receptor tyrosine kinase; g) compounds targeting, decreasing or inhibiting the activity of the Kit/SCFR receptor tyrosine kinase, such as imatinib; h) compounds targeting, decreasing or inhibiting the activity of the C-kit receptor tyrosine kinases, which are part of the PDGFR family, such as compounds which target, decrease or inhibit the activity of the c-Kit receptor tyrosine kinase family, especially compounds which inhibit the c-Kit receptor, such as imatinib; i) compounds targeting, decreasing or inhibiting the activity of members of the c-Abl family, their gene-fusion products (e.g. BCR-Abl kinase) and mutants, such as compounds which target decrease or inhibit the activity of c-Abl family members and their gene fusion products, such as an N-phenyl-2-pyrimidine-amine derivative, such as imatinib or nilotinib (AMN107); PD180970; AG957; NSC 680410; PD173955 from ParkeDavis; or dasatinib (BMS-354825); j) compounds targeting, decreasing or inhibiting the activity of members of the protein kinase C (PKC) and Raf family of serine/threonine kinases, members of the MEK, SRC, JAK/pan-JAK, FAK, PDK1, PKB/Akt, Ras/MAPK, PI3K, SYK, TYK2, BTK and TEC family, and/or members of the cyclin-dependent kinase family (CDK) including staurosporine derivatives, such as midostaurin; examples of further compounds include UCN-01, safingol, BAY 43-9006, Bryostatin 1, Perifosine; Ilmofosine; RO 318220 and RO 320432; GO 6976; lsis 3521; LY333531/LY379196; isochinoline compounds; FTIs; PD184352 or QAN697 (a PI3K inhibitor) or AT7519 (CDK inhibitor); k) compounds targeting, decreasing or inhibiting the activity of protein-tyrosine kinase inhibitors, such as compounds which target, decrease or inhibit the activity of protein-tyrosine kinase inhibitors include imatinib mesylate (Gleevec™) or tyrphostin such as Tyrphostin A23/RG-50810; AG 99; Tyrphostin AG 213; Tyrphostin AG 1748; Tyrphostin AG 490; Tyrphostin B44; Tyrphostin B44 (+) enantiomer; Tyrphostin AG 555; AG 494; Tyrphostin AG 556, AG957 and adaphostin (4-{[(2,5-dihydroxyphenyl)methyl]amino}-benzoic acid adamantyl ester; NSC 680410, adaphostin); 1) compounds targeting, decreasing or inhibiting the activity of the epidermal growth factor family of receptor tyrosine kinases (EGFR₁ ErbB2, ErbB3, ErbB4 as homo- or heterodimers) and their mutants, such as compounds which target, decrease or inhibit the activity of the epidermal growth factor receptor family are especially compounds, proteins or antibodies which inhibit members of the EGF receptor tyrosine kinase family, such as EGF receptor, ErbB2, ErbB3 and ErbB4 or bind to EGF or EGF related ligands, CP 358774, ZD 1839, ZM 105180; trastuzumab (Herceptin™), cetuximab (Erbitux™), Iressa, Tarceva, OSI-774, C₁₋₁₀₃₃, EKB-569, GW-2016, E1.1, E2.4, E2.5, E6.2, E6.4, E2.11, E6.3 or E7.6.3, and 7H-pyrrolo-[2,3-d]pyrimidine derivatives; m) compounds targeting, decreasing or inhibiting the activity of the c-Met receptor, such as compounds which target, decrease or inhibit the activity of c-Met, especially compounds which inhibit the kinase activity of c-Met receptor, or antibodies that target the extracellular domain of c-Met or bind to HGF, n) compounds targeting, decreasing or inhibiting the kinase activity of one or more JAK family members (JAK1/JAK2/JAK3/TYK2 and/or pan-JAK), including but not limited to PRT-062070, SB-1578, baricitinib, pacritinib, momelotinib, VX-509, AZD-1480, TG-101348, tofacitinib, and ruxolitinib; o) compounds targeting, decreasing or inhibiting the kinase activity of PI3 kinase (PI3K) including but not limited to ATU-027, SF-1126, DS-7423, PBI-05204, GSK-2126458, ZSTK-474, buparlisib, pictrelisib, PF-4691502, BYL-719, dactolisib, XL-147, XL-765, and idelalisib; and q) compounds targeting, decreasing or inhibiting the signaling effects of hedgehog protein (Hh) or smoothened receptor (SMO) pathways, including but not limited to cyclopamine, vismodegib, itraconazole, erismodegib, and IPI-926 (saridegib).

The term “PI3K inhibitor” as used herein includes, but is not limited to compounds having inhibitory activity against one or more enzymes in the phosphatidylinositol-3-kinase family, including, but not limited to PI3Kα, PI3Kγ, PI3Kδ, PI3Kβ, PI3K-C2α, PI3K-C2β, PI3K-C2γ, Vps34, p110-α, p110-β, p110-γ, p110-δ, p85-α, p85-β, p55-γ, p150, p101, and p87. Examples of PI3K inhibitors useful in this invention include but are not limited to ATU-027, SF-1126, DS-7423, PBI-05204, GSK-2126458, ZSTK-474, buparlisib, pictrelisib, PF-4691502, BYL-719, dactolisib, XL-147, XL-765, and idelalisib.

The term “Bcl-2 inhibitor” as used herein includes, but is not limited to compounds having inhibitory activity against B-cell lymphoma 2 protein (Bcl-2), including but not limited to ABT-199, ABT-731, ABT-737, apogossypol, Ascenta's pan-Bcl-2 inhibitors, curcumin (and analogs thereof), dual Bcl-2/Bcl-xL inhibitors (Infinity Pharmaceuticals/Novartis Pharmaceuticals), Genasense (G3139), HA14-1 (and analogs thereof; see WO2008118802), navitoclax (and analogs thereof, see U.S. Pat. No. 7,390,799), NH-1 (Shenayng Pharmaceutical University), obatoclax (and analogs thereof, see WO 2004/106328, hereby incorporated by reference), S-001 (Gloria Pharmaceuticals), TW series compounds (Univ. of Michigan), and venetoclax. In some embodiments the Bcl-2 inhibitor is a small molecule therapeutic. In some embodiments the Bcl-2 inhibitor is a peptidomimetic.

The term “BTK inhibitor” as used herein includes, but is not limited to compounds having inhibitory activity against Bruton's Tyrosine Kinase (BTK), including, but not limited to AVL-292 and ibrutinib.

The term “SYK inhibitor” as used herein includes, but is not limited to compounds having inhibitory activity against spleen tyrosine kinase (SYK), including but not limited to PRT-062070, R-343, R-333, Excellair, PRT-062607, and fostamatinib.

Further examples of BTK inhibitory compounds, and conditions treatable by such compounds in combination with compounds of this invention can be found in WO 2008/039218 and WO 2011/090760, the entirety of which are incorporated herein by reference.

Further examples of SYK inhibitory compounds, and conditions treatable by such compounds in combination with compounds of this invention can be found in WO 2003/063794, WO 2005/007623, and WO 2006/078846, the entirety of which are incorporated herein by reference.

Further examples of PI3K inhibitory compounds, and conditions treatable by such compounds in combination with compounds of this invention can be found in WO 2004/019973, WO 2004/089925, WO 2007/016176, U.S. Pat. No. 8,138,347, WO 2002/088112, WO 2007/084786, WO 2007/129161, WO 2006/122806, WO 2005/113554, and WO 2007/044729 the entirety of which are incorporated herein by reference.

Further examples of JAK inhibitory compounds, and conditions treatable by such compounds in combination with compounds of this invention can be found in WO 2009/114512, WO 2008/109943, WO 2007/053452, WO 2000/142246, and WO 2007/070514, the entirety of which are incorporated herein by reference.

Further anti-angiogenic compounds include compounds having another mechanism for their activity, e.g. unrelated to protein or lipid kinase inhibition e.g. thalidomide (Thalomid™) and TNP-470.

Examples of proteasome inhibitors useful for use in combination with a disclosed lipid prodrug include, but are not limited to, bortezomib, disulfiram, epigallocatechin-3-gallate (EGCG), salinosporamide A, carfilzomib, ONX-0912, CEP-18770, and MLN9708.

Compounds which target, decrease or inhibit the activity of a protein or lipid phosphatase are e.g. inhibitors of phosphatase 1, phosphatase 2A, or CDC25, such as okadaic acid or a derivative thereof.

Compounds which induce cell differentiation processes include, but are not limited to, retinoic acid, α- γ- or δ-tocopherol or α- γ- or δ-tocotrienol.

The term “cyclooxygenase inhibitor” as used herein includes, but is not limited to, Cox-2 inhibitors, 5-alkyl substituted 2-arylaminophenylacetic acid and derivatives, such as celecoxib (Celebrex™), etoricoxib, valdecoxib or a 5-alkyl-2-arylaminophenylacetic acid, such as 5-methyl-2-(2′-chloro-6′-fluoroanilino)phenyl acetic acid, lumiracoxib.

The term “bisphosphonates” as used herein includes, but is not limited to, etridonic, clodronic, tiludronic, pamidronic, alendronic, ibandronic, risedronic and zoledronic acid. Etridonic acid is marketed under the trade name Didronel™. Clodronic acid is marketed under the trade name Bonefos™. Tiludronic acid is marketed under the trade name Skelid™. Pamidronic acid is marketed under the trade name Aredia™. Alendronic acid is marketed under the trade name Fosamax™. Ibandronic acid is marketed under the trade name Bondranat™. Risedronic acid is marketed under the trade name Actonel™. Zoledronic acid is marketed under the trade name Zometa™. The term “mTOR inhibitors” relates to compounds which inhibit the mammalian target of rapamycin (mTOR) and which possess antiproliferative activity such as sirolimus (Rapamune®), everolimus (Certican™), CCI-779 and ABT578.

The term “heparanase inhibitor” as used herein refers to compounds which target, decrease or inhibit heparin sulfate degradation. The term includes, but is not limited to, PI-88. The term “biological response modifier” as used herein refers to a lymphokine or interferons.

The term “inhibitor of Ras oncogenic isoforms”, such as H-Ras, K-Ras, or N-Ras, as used herein refers to compounds which target, decrease or inhibit the oncogenic activity of Ras; for example, a “farnesyl transferase inhibitor” such as L-744832, DK8G557 or R115777 (Zarnestra™). The term “telomerase inhibitor” as used herein refers to compounds which target, decrease or inhibit the activity of telomerase. Compounds which target, decrease or inhibit the activity of telomerase are especially compounds which inhibit the telomerase enzyme, such as telomestatin.

The term “methionine aminopeptidase inhibitor” as used herein refers to compounds which target, decrease or inhibit the activity of methionine aminopeptidase. Compounds which target, decrease or inhibit the activity of methionine aminopeptidase include, but are not limited to, bengamide or a derivative thereof.

The term “proteasome inhibitor” as used herein refers to compounds which target, decrease or inhibit the activity of the proteasome. Compounds which target, decrease or inhibit the activity of the proteasome include, but are not limited to, Bortezomib (Velcade™) and MLN 341.

The term “matrix metalloproteinase inhibitor” or (“MMP” inhibitor) as used herein includes, but is not limited to, collagen peptidomimetic and nonpeptidomimetic inhibitors, tetracycline derivatives, e.g. hydroxamate peptidomimetic inhibitor batimastat and its orally bioavailable analogue marimastat (BB-2516), prinomastat (AG3340), metastat (NSC 683551) BMS-279251, BAY 12-9566, TAA211, MMI270B or AAJ996.

The term “compounds used in the treatment of hematologic malignancies” as used herein includes, but is not limited to, FMS-like tyrosine kinase inhibitors, which are compounds targeting, decreasing or inhibiting the activity of FMS-like tyrosine kinase receptors (Flt-3R); interferon, 1-β-D-arabinofuransylcytosine (ara-c) and bisulfan; and ALK inhibitors, which are compounds which target, decrease or inhibit anaplastic lymphoma kinase.

Compounds which target, decrease or inhibit the activity of FMS-like tyrosine kinase receptors (Flt-3R) are especially compounds, proteins or antibodies which inhibit members of the Flt-3R receptor kinase family, such as PKC412, midostaurin, a staurosporine derivative, SU11248 and MLN518.

The term “HSP90 inhibitors” as used herein includes, but is not limited to, compounds targeting, decreasing or inhibiting the intrinsic ATPase activity of HSP90; degrading, targeting, decreasing or inhibiting the HSP90 client proteins via the ubiquitin proteosome pathway. Compounds targeting, decreasing or inhibiting the intrinsic ATPase activity of HSP90 are especially compounds, proteins or antibodies which inhibit the ATPase activity of HSP90, such as 17-allylamino, 17-demethoxygeldanamycin (17AAG), a geldanamycin derivative; other geldanamycin related compounds; radicicol and HDAC inhibitors.

The term “antiproliferative antibodies” as used herein includes, but is not limited to, trastuzumab (Herceptin™), Trastuzumab-DM1, erbitux, bevacizumab (Avastin™), rituximab (Rituxan®), PRO64553 (anti-CD40) and 2C4 Antibody. By antibodies is meant intact monoclonal antibodies, polyclonal antibodies, multispecific antibodies formed from at least 2 intact antibodies, and antibodies fragments so long as they exhibit the desired biological activity.

For the treatment of acute myeloid leukemia (AML), a disclosed lipid prodrug can be used in combination with standard leukemia therapies, especially in combination with therapies used for the treatment of AML. In particular, a disclosed lipid prodrug can be administered in combination with, for example, farnesyl transferase inhibitors and/or other drugs useful for the treatment of AML, such as Daunorubicin, Adriamycin, Ara-C, VP-16, Teniposide, Mitoxantrone, Idarubicin, Carboplatinum and PKC412.

Other anti-leukemic compounds include, for example, Ara-C, a pyrimidine analog, which is the 2′-alpha-hydroxy ribose (arabinoside) derivative of deoxycytidine. Also included is the purine analog of hypoxanthine, 6-mercaptopurine (6-MP) and fludarabine phosphate. Compounds which target, decrease or inhibit activity of histone deacetylase (HDAC) inhibitors such as sodium butyrate and suberoylanilide hydroxamic acid (SAHA) inhibit the activity of the enzymes known as histone deacetylases. Specific HDAC inhibitors include MS275, SAHA, FK228 (formerly FR901228), Trichostatin A and compounds disclosed in U.S. Pat. No. 6,552,065 including, but not limited to, N-hydroxy-3-[4-[[[2-(2-methyl-1H-indol-3-yl)-ethyl]-amino]methyl]phenyl]-2E-2-propenamide, or a pharmaceutically acceptable salt thereof and N-hydroxy-3-[4-[(2-hydroxyethyl){2-(1H-indol-3-yl)ethyl]-amino]methyl]phenyl]-2E-2-propenamide, or a pharmaceutically acceptable salt thereof, especially the lactate salt. Somatostatin receptor antagonists as used herein refer to compounds which target, treat or inhibit the somatostatin receptor such as octreotide, and SOM230. Tumor cell damaging approaches refer to approaches such as ionizing radiation. The term “ionizing radiation” referred to above and hereinafter means ionizing radiation that occurs as either electromagnetic rays (such as X-rays and gamma rays) or particles (such as alpha and beta particles). Ionizing radiation is provided in, but not limited to, radiation therapy and is known in the art. See Hellman, Principles of Radiation Therapy, Cancer, in Principles and Practice of Oncology, Devita et al., Eds., 4^(th) Edition, Vol. 1, pp. 248-275 (1993).

Also included are EDG binders and ribonucleotide reductase inhibitors. The term “EDG binders” as used herein refers to a class of immunosuppressants that modulates lymphocyte recirculation, such as FTY720. The term “ribonucleotide reductase inhibitors” refers to pyrimidine or purine nucleoside analogs including, but not limited to, fludarabine and/or cytosine arabinoside (ara-C), 6-thioguanine, 5-fluorouracil, cladribine, 6-mercaptopurine (especially in combination with ara-C against ALL) and/or pentostatin. Ribonucleotide reductase inhibitors are especially hydroxyurea or 2-hydroxy-1H-isoindole-1,3-dione derivatives.

Also included are in particular those compounds, proteins or monoclonal antibodies of VEGF such as 1-(4-chloroanilino)-4-(4-pyridylmethyl)phthalazine or a pharmaceutically acceptable salt thereof, 1-(4-chloroanilino)-4-(4-pyridylmethyl)phthalazine succinate; Angiostatin™; Endostatin™; anthranilic acid amides; ZD4190; ZD6474; SU5416; SU6668; bevacizumab; or anti-VEGF antibodies or anti-VEGF receptor antibodies, such as rhuMAb and RHUFab, VEGF aptamer such as Macugon; FLT-4 inhibitors, FLT-3 inhibitors, VEGFR-2 IgGI antibody, Angiozyme (RPI 4610) and Bevacizumab (Avastin™).

Photodynamic therapy as used herein refers to therapy which uses certain chemicals known as photosensitizing compounds to treat or prevent cancers. Examples of photodynamic therapy include treatment with compounds, such as Visudyne™ and porfimer sodium.

Angiostatic steroids as used herein refers to compounds which block or inhibit angiogenesis, such as, e.g., anecortave, triamcinolone, hydrocortisone, 11-α-epihydrocotisol, cortexolone, 17α-hydroxyprogesterone, corticosterone, desoxycorticosterone, testosterone, estrone and dexamethasone.

Other chemotherapeutic compounds include, but are not limited to, plant alkaloids, hormonal compounds and antagonists; biological response modifiers, preferably lymphokines or interferons; antisense oligonucleotides or oligonucleotide derivatives; shRNA or siRNA; or miscellaneous compounds or compounds with other or unknown mechanism of action.

Disclosed lipid prodrugs are also useful as co-therapeutic compounds for use in combination with other drug substances such as anti-inflammatory, bronchodilatory or antihistamine drug substances, particularly in the treatment of obstructive or inflammatory airways diseases such as those mentioned hereinbefore, for example as potentiators of therapeutic activity of such drugs or as a means of reducing required dosaging or potential side effects of such drugs. A disclosed lipid prodrug may be mixed with the other drug substance in a fixed pharmaceutical composition or it may be administered separately, before, simultaneously with or after the other drug substance. Accordingly the invention includes a combination of a disclosed lipid prodrug as hereinbefore described with an anti-inflammatory, bronchodilatory, antihistamine or anti-tussive drug substance, said disclosed lipid prodrug and said drug substance being in the same or different pharmaceutical composition.

Suitable anti-inflammatory drugs include steroids, in particular glucocorticosteroids such as budesonide, beclamethasone dipropionate, fluticasone propionate, ciclesonide or mometasone furoate; non-steroidal glucocorticoid receptor agonists; LTB4 antagonists such LY293111, CGS025019C, CP-195543, SC-53228, BILL 284, ONO 4057, SB 209247; LTD4 antagonists such as montelukast and zafirlukast; PDE4 inhibitors such cilomilast (Ariflo® GlaxoSmithKline), Roflumilast (Byk Gulden), V-11294A (Napp), BAY19-8004 (Bayer), SCH-351591 (Schering-Plough), Arofylline (Almirall Prodesfarma), PD189659/PD168787 (Parke-Davis), AWD-12-281 (Asta Medica), CDC-801 (Celgene), SeICID™ CC-10004 (Celgene), VM554/UM565 (Vernalis), T-440 (Tanabe), KW-4490 (Kyowa Hakko Kogyo); A2a agonists; A2b antagonists; and beta-2 adrenoceptor agonists such as albuterol (salbutamol), metaproterenol, terbutaline, salmeterol fenoterol, procaterol, and especially, formoterol and pharmaceutically acceptable salts thereof. Suitable bronchodilatory drugs include anticholinergic or antimuscarinic compounds, in particular ipratropium bromide, oxitropium bromide, tiotropium salts and CHF 4226 (Chiesi), and glycopyrrolate.

Suitable antihistamine drug substances include cetirizine hydrochloride, acetaminophen, clemastine fumarate, promethazine, loratidine, desloratidine, diphenhydramine and fexofenadine hydrochloride, activastine, astemizole, azelastine, ebastine, epinastine, mizolastine and tefenadine.

Other useful combinations of disclosed lipid prodrugs with anti-inflammatory drugs are those with antagonists of chemokine receptors, e.g. CCR-1, CCR-2, CCR-3, CCR-4, CCR-5, CCR-6, CCR-7, CCR-8, CCR-9 and CCR10, CXCR1, CXCR2, CXCR3, CXCR4, CXCR5, particularly CCR-5 antagonists such as Schering-Plough antagonists SC-351125, SCH-55700 and SCH-D, and Takeda antagonists such as N-[[4-[[[6,7-dihydro-2-(4-methylphenyl)-5H-benzo-cyclohepten-8-yl]carbonyl]amino]phenyl]-methyl]tetrahydro-N,N-dimethyl-2H-pyran-4-aminium chloride (TAK-770).

In some embodiments, the additional therapeutic agent is selected from Abacavir, Abiraterone, Acetylcysteine, acyclovir, adefovir dipivoxil, Alatrofloxacin, Albendazole, albuterol, Alendronic acid, Altropane, Amifostine, Aminolevulinic acid, amiodarone (e.g. cosolvent-free), Amisulpride, amitriptyline, amprenavir, anastrozole, Apomorphine, apremilast, Arbutamine, Argatroban, Arsenic trioxide, aspirin, Atazanavir/cobicistat, Atorvastatin, Avibactam/ceftazidime, Azacitidine, azathioprine, Azithromycin, Belinostat, bendamustine, Bexarotene, Biapenem, Bicalutamide, Bortezomib, Bosentan, bosutinib, Bromfenac, Buprenorphine, Bupropion, Busulfan, C₁ esterase inhibitor, Caffeine, calcium levofolinate, Cangrelor, capecitabine, capsaicin, Carfilzomib, Carvedilol, Cefepime, Ceftaroline fosamil, Ceftazidime, Ceftibuten, Ceftolozane/tazobactam, celecoxib, Celgosivir, chlorambucil, Cidofovir, Ciprofloxacin, Cladribine, Clazosentan, Clofarabine, Clopidogrel, cyclophosphamide, cytarabine, danazol, Dantrolene, dasatinib, Daunorubicin, Decitabine, Deferiprone, delavirdine, Deoxycholic acid, deoxythymidine, Dexamethasone, Dexmedetomidine, Dexrazoxane, Diclofenac, Didanosine, diethylcarbamazine, Docetaxel, Dolasetron, Doripenem, Doxapram, Doxercalciferol, Doxorubicin, doxycycline, Efavirenz, Eflapegrastim, elvitegravir, emtricitabine, Entacapone, Epacadostat, epinephrine, epitiostanol, Epoprostenol, ergotamine, Eribulin, Esomeprazole, estradiol, estrogen, etonogestrel, Ezetimibe, Ezetimibe/simvastatin, Fasudil, Fenoldopam, Fentanyl, Ferric carboxymaltose, Finasteride, Fingolimod, Florbenazine F18, Florbetaben F 18, florbetapir F 18, Fludarabine, Fluorine 18 AV 1451, fluorouracil, Fluoxymesterone, Flurpiridaz F-18, Flutafuranol F 18, Flutemetamol F 18, Fomepizole, Fosaprepitant, Fosphenytoin, Fospropofol, fulvestrant, Furosemide, Gadobenic acid, Gadobutrol, Gadoversetamide, Gadoxetate disodium, gemcitabine, Glimepiride, Granisetron, Guadecitabine, hydroxychloroquine, Ibandronic acid, ibuprofen, imatinib, Imiquimod, Iobenguane I-123, Ioflupane 123I, Ioxilan, Irinotecan, Isavuconazonium, isosorbidedinitrate, ivermectin, ixabepilone, labelalol, Lacosamide, lamivudine, Lamotrigine, Lansoprazole, Lapatinib, L-dopa, leflunomide, Letermovir, Letrozole, Levetiracetam, Levofloxacin, Levothyroxine, Lidocaine, lidocaine, Linezolid, Lobaplatin, Lomitapide, lopinavir, maraviroc, Meloxicam, melphalan, mercaptopurine, Meropenem, Mesna, methotrexate, Methylnaltrexone, Methylphenidate, metoprolol, midazolam, Minocycline IV, Mitoxantrone, Moxifloxacin, Mycophenolate mofetil, naloxone, naltrexone, naproxen, Nefazodone, nelarabine, nelfinavir, Nevirapine, nilotinib, Nilutamide, nitrosoureas, nortriptyline, Omacetaxine mepesuccinate, Omadacycline, Omeprazole, an opioid such as codeine, meperidine, fentanyl, morphine, oxycodone, hydrocodone, hydromorphone, or methadone, Oxaliplatin, oxprenolol, Oxybutynin, Oxymetholone, paclitaxel (Taxol®), Palonosetron, Pantoprazole, Paracetamol, Pemetrexed, pentazocine, Pentostatin, Phenylephrine, Pirmenol, platinum, Plazomicin, Plerixafor, ponatinib, pralatrexate, predisone, prednisolone, Propofol, propranolol, Quinapril, Radium-223 chloride, Raloxifene, raltegravir, Raltitrexed, Ramatroban, Regadenoson, Remifentanil, Remimazolam besylate, rilpivirine, rinotecan, Risperidone, Ritonavir, Rivastigmine, rofecoxib, Romidepsin, Ropeginterferon alfa-2b, Rotigotine, salbutamol, Salmeterol, Samarium 153 lexidronam, saquinavir, Selegiline, Sertraline, Sildenafil, Simvastatin, Sorivudine, Stavudine, sulfasalazine, Sulfur hexafluoride, Sumatriptan, Sunitinib, Tacrine, tamoxifen, Technetium Tc 99m trofolastat, Tedizolid, Temozolomide, tenofovir, Terbinafine, Testosterone propionate, thiotepa, Tianeptine, Tigecycline, Tizanidine, Topiramate, Topotecan, toremifene, Treprostinil, Tretinoin, Triciribine, verapamil, Verteporfin, Vinorelbine, Vismodegib, Voglibose, zalcitabine, zidovudine, Zileuton, or Zoledronic acid; or a pharmaceutically acceptable salt thereof.

The structure of the active compounds identified by code numbers, generic or trade names may be taken from the actual edition of the standard compendium “The Merck Index” or from databases, e.g. Patents International (e.g. IMS World Publications).

A disclosed lipid prodrug may also be used in combination with known therapeutic processes, for example, the administration of hormones or radiation. In certain embodiments, a disclosed lipid prodrug is used as a radiosensitizer, especially for the treatment of tumors which exhibit poor sensitivity to radiotherapy.

The disclosed lipid prodrugs and compositions, and any co-administered additional therapeutic agents, according to the method of the present invention, may be administered using any amount and any route of administration effective for treating or lessening the severity of a disease, disorder, or condition such as cancer, an autoimmune disorder, a proliferative disorder, an inflammatory disorder, a neurodegenerative or neurological disorder, schizophrenia, a bone-related disorder, liver disease, or a cardiac disorder. The exact amount required will vary from subject to subject, depending on the species, age, and general condition of the subject, the severity of the infection, the particular agent, its mode of administration, and the like. Disclosed lipid prodrugs are preferably formulated in dosage unit form for ease of administration and uniformity of dosage. The expression “dosage unit form” as used herein refers to a physically discrete unit of agent appropriate for the patient to be treated. It will be understood, however, that the total daily usage of a disclosed lipid prodrug or composition thereof and any co-administered additional therapeutic agents will be decided by the attending physician within the scope of sound medical judgment. The specific effective dose level for any particular patient or organism will depend upon a variety of factors including the disorder being treated and the severity of the disorder; the activity of the specific lipid prodrug employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration, route of administration, and rate of excretion of the specific lipid prodrug or composition; the duration of the treatment; drugs used in combination or coincidental with the specific lipid prodrug or composition employed, and like factors well known in the medical arts. The term “patient,” as used herein, means an animal, preferably a mammal, and most preferably a human.

4. Methods of Making Lipid Prodrugs General Methods for Making Lipid Prodrugs

The lipid prodrug compounds of this invention may be prepared or isolated in general by synthetic and/or semi-synthetic methods known to those skilled in the art for analogous compounds and by methods described in detail in the Examples, herein.

The therapeutic agents comprised in disclosed lipid prodrugs (e.g., conjugated to a glyceride-based prodrug) may be purchased commercially or prepared by organic synthesis, semi-synthesis, fermentation (e.g. with viral vectors), and like methods known in the art.

In some embodiments, protecting groups (as defined below) can be used to manipulate therapeutic agents in preparation for conjugation to the remainder of the lipid prodrug structure, for example, to prevent undesired side reactions from taking place.

In the synthesis methods described herein, where a particular protecting group (“PG”), leaving group (“LG”), or transformation condition is depicted, one of ordinary skill in the art will appreciate that other protecting groups, leaving groups, and transformation conditions are also suitable and are contemplated. Such groups and transformations are described in detail in March's Advanced Organic Chemistry: Reactions, Mechanisms, and Structure, M. B. Smith and J. March, 7^(th) Edition, John Wiley & Sons, 2013, Comprehensive Organic Transformations, R. C. Larock, 3^(rd) Edition, John Wiley & Sons, 2018, and Protective Groups in Organic Synthesis, P. G. M. Wuts, 5^(th) edition, John Wiley & Sons, 2014, the entirety of each of which is hereby incorporated herein by reference.

As used herein, the phrase “leaving group” (LG) includes, but is not limited to, halogens (e.g., fluoride, chloride, bromide, iodide), sulfonates (e.g., mesylate, tosylate, benzenesulfonate, brosylate, nosylate, triflate), diazonium, and the like.

As used herein, the phrase “oxygen protecting group” includes, for example, carbonyl protecting groups, hydroxyl protecting groups, etc. Hydroxyl protecting groups are well known in the art and include those described in detail in Protective Groups in Organic Synthesis, P. G. M. Wuts, 5^(th) edition, John Wiley & Sons, 2014, and Philip Kocienski, in Protecting Groups, Georg Thieme Verlag Stuttgart, New York, 1994, the entireties of which are incorporated herein by reference. Examples of suitable hydroxyl protecting groups include, but are not limited to, esters, allyl ethers, ethers, silyl ethers, alkyl ethers, arylalkyl ethers, and alkoxyalkyl ethers. Examples of such esters include formates, acetates, carbonates, and sulfonates. Specific examples include formate, benzoyl formate, chloroacetate, trifluoroacetate, methoxyacetate, triphenylmethoxyacetate, p-chlorophenoxyacetate, 3-phenylpropionate, 4-oxopentanoate, 4,4-(ethylenedithio)pentanoate, pivaloate (trim ethyl acetyl), crotonate, 4-methoxy-crotonate, benzoate, p-benzylbenzoate, 2,4,6-trimethylbenzoate, carbonates such as methyl, 9-fluorenylmethyl, ethyl, 2,2,2-trichloroethyl, 2-(trimethylsilyl)ethyl, 2-(phenyl sulfonyl)ethyl, vinyl, allyl, and p-nitrobenzyl. Examples of such silyl ethers include trimethylsilyl, triethylsilyl, t-butyldimethyl silyl, t-butyldiphenylsilyl, triisopropylsilyl, and other trialkylsilyl ethers. Alkyl ethers include methyl, benzyl, p-methoxybenzyl, 3,4-dimethoxybenzyl, trityl, t-butyl, allyl, and allyloxycarbonyl ethers or derivatives. Alkoxyalkyl ethers include acetals such as methoxymethyl, methylthiomethyl, (2-methoxyethoxy)methyl, benzyloxymethyl, beta-(trimethylsilyl)ethoxymethyl, and tetrahydropyranyl ethers. Examples of arylalkyl ethers include benzyl, p-methoxybenzyl (MPM), 3,4-dimethoxybenzyl, o-nitrobenzyl, p-nitrobenzyl, p-halobenzyl, 2,6-dichlorobenzyl, p-cyanobenzyl, and 2- and 4-picolyl.

Amino protecting groups are well known in the art and include those described in detail in Protective Groups in Organic Synthesis, P. G. M. Wuts, 5^(th) edition, John Wiley & Sons, 2014, and Philip Kocienski, in Protecting Groups, Georg Thieme Verlag Stuttgart, New York, 1994, the entireties of which are incorporated herein by reference. Suitable amino protecting groups include, but are not limited to, aralkylamines, carbamates, cyclic imides, allyl amines, amides, and the like. Examples of such groups include t-butyloxycarbonyl (Boc), ethyloxycarbonyl, methyloxycarbonyl, trichloroethyloxycarbonyl, allyloxycarbonyl (Alloc), benzyloxocarbonyl (Cbz), allyl, phthalimide, benzyl (Bn), fluorenylmethylcarbonyl (Fmoc), formyl, acetyl, chloroacetyl, dichloroacetyl, trichloroacetyl, phenylacetyl, trifluoroacetyl, benzoyl, and the like.

One of skill in the art will appreciate that various functional groups present in compounds of the invention such as aliphatic groups, alcohols, carboxylic acids, esters, amides, aldehydes, halogens and nitriles can be interconverted by techniques well known in the art including, but not limited to reduction, oxidation, esterification, hydrolysis, partial oxidation, partial reduction, halogenation, dehydration, partial hydration, and hydration. See, for example, March's Advanced Organic Chemistry: Reactions, Mechanisms, and Structure, M. B. Smith and J. March, 7^(th) Edition, John Wiley & Sons, 2013, Comprehensive Organic Transformations, R. C. Larock, 3^(rd) Edition, John Wiley & Sons, 2018, the entirety of each of which is incorporated herein by reference. Such interconversions may require one or more of the aforementioned techniques, and certain methods for synthesizing compounds of the invention are described below.

As a general strategy, compounds of the present invention may be synthesized via one of the following routes:

Diacid chlorides i, which are readily available from the corresponding malonic acids, can be reacted with a diglyceride such as ii in the presence of pyridine or another appropriate base to give acid-triglyceride (acid-TG) iii (see Scheme 1). Formula iii is shown with C₁₅H31 fatty acid side chains, but other fatty acids (such as those described above) can be substituted in this and other Formulas described below.

In cases where acid anhydride i-a is available, acid-TG iii can be generated by ring-opening with diglyceride ii in the presence of pyridine or another appropriate base (Scheme 2). This method works best when R⁴ and R⁵ of acid anhydride i-a are identical, e.g. both Me, but will result in a regioisomeric mixture of acid-TG products iv when R⁴ and R⁵ differ from each other. Consequently, other methods, such as that outlined in Scheme 3, can advantageously be employed in this circumstance.

To obtain acid-TG iv as a single regioisomer in the specific example where R⁴=Me or other alkyl or substitution and R⁵═H, the known carboxylic acid v (Lienard, B. M. R. et al., Org. Biomol. Chem. 2008, 6, (13), 2282-2292) can be used as a starting point (see Scheme 3). Coupling of acid v with 1,3-DG ii under standard conditions produces TBDPS protected triglyceride vi, which can be treated with appropriate conditions such as TBAF and AcOH to afford alcohol vii. A two-step oxidation process (for example, PCC, then KMn04) can then be used to transform alcohol vii into the desired acid-TG iv via the intermediate aldehyde viii.

For the synthesis of compounds containing an acetal self-immolative (ASI) group between the pharmaceutical agent and the alkyl spacer, the alcohol-bearing parent molecule must be functionalized and activated prior to conjugation with acid-triglyceride iii as outlined above in Scheme 4. Treatment of an alcohol with DMSO in a mixture of acetic anhydride and acetic acid results in the formation of (methylthio)methyl (MTM) ether ix. Activation of MTM ether ix using sulfuryl chloride forms a presumed sulfoxide species that can react with the carboxylate of acid-triglyceride iv to give the target compound x.

In cases where the pharmaceutical agent contains an alcohol, phenol or amine (primary or secondary) functional group, a modified version of the acetal self-immolative group can be used where an additional carboxy group is included. Reaction of the parent drug with a chloroalkyl chloroformate gives chloroalkyl carbonates (shown) or carbamates xi (see Scheme 5). Displacement of the halide leaving group is then accomplished by treatment with the carboxylate derived from acid-TG iv in an appropriate solvent such as refluxing toluene to afford the target compound xii.

For the synthesis of prodrugs containing a trimethyl lock (TML) self-immolative group (Levine, M. N.; Raines, R. T. Chem. Sci. 2012, 3, 2412-2420, hereby incorporated by reference) between the pharmaceutical agent and the alkyl spacer to facilitate systemic release of the parent molecule, the acid-triglyceride iv must be functionalized with the TML moiety prior to conjugation with a pharmaceutical agent as outlined in Scheme 6. Coupling of acid-TG iv with TML phenol xiii under standard conditions gives triglyceride xiv, which can be deprotected under acidic conditions (10-camphorsulfonic acid) to give alcohol xv. Sequential oxidation of alcohol xv firstly to aldehyde xvi and then acid xvii, followed by coupling to either an alcohol (shown), amine or sulfonamide-containing pharmaceutical agent under standard conditions can give the target compound xviii.

Scheme 7. Synthesis of Compounds of Formula xxiv Wherein -M- is a p-Hydroxybenzyl Carbonyl (PHB) Self-Immolative Group.

For the synthesis of compounds containing a p-hydroxybenzyl (PHB) carbonyl self-immolative group, the primary hydroxyl group of p-hydroxybenzyl alcohol (xix) is first protected as a silyl ether and the free phenolic hydroxyl group coupled with acid-TG iv to give PHB triglyceride xxi (see Scheme 7). After removal of the silicon protecting group, primary alcohol xxii can be activated by treatment with p-nitrophenyl (PNP) chloroformate to give PNP carbonate xxiii. Displacement of the PNP group is then achieved by reaction with a pharmaceutical agent (A-OH shown) under basic conditions to give the desired compound xxiv.

Without wishing to be bound by theory, it is believed that the flipped-ester self-immolative (FSI) group can liberate the free pharmaceutical agent by a cyclization mechanism, resulting in loss of either a four-carbon (FSI-4) or five-carbon (FSI-5) lactone. Alternatively, liberation of the agent may occur by a chemical or enzymatic mechanism in vivo. FSI prodrugs can be synthesized by coupling the pharmaceutical agent (A-OH shown) with either 4-bromobutyric acid (m=1) or 5-bromovaleric acid (m=2) (xxv) to give bromide xxvi (see Scheme 8). Displacement of bromide xxvi using the carboxylate derived from acid-TG iv generates the desired ester bond in target compound xxvii.

EXEMPLIFICATION Example 1: Synthesis of Intermediates List of Abbreviations

-   equiv or eq: molar equivalents -   rt or RT: room temperature -   UV: ultra violet -   HPLC: high pressure liquid chromatography -   Rt: retention time -   LCMS or LC-MS: liquid chromatography-mass spectrometry -   NMR: nuclear magnetic resonance -   TLC: thin layer chromatography -   sat: saturated -   aq: aqueous -   Ac: acetyl -   BINAP: (±)-2,2′-Bis(diphenylphosphino)-1,1′-binaphthalene -   Bn: Benzyl -   DBU: 1,8-Diazabicyclo[5.4.0]undec-7-ene -   DCC: N,N′-Dicyclohexylcarbodiimide -   DCM: Dichloromethane -   DCE: Dichloroethane -   DEA: Diethylamine -   DIPA: Diisopropylamine -   DMF: N,N-dimethylformamide -   DMSO: dimethylsulfoxide -   DMPU: N,N′-Dimethylpropyleneurea -   ACN or MeCN: acetonitrile -   DIPEA: diisopropylethylamine -   EA or EtOAc: ethyl acetate -   EDCI, EDC, or EDAC: 1-Ethyl-3-(3-dimethylaminopropyl)carbodiimide -   TEA: triethylamine -   THF: tetrahydrofuran -   TBS: tert-butyldimethylsilyl -   KHMDS: potassium hexamethyl disilylazide -   Tf: trifluoromethanesulfonate -   Ms: methanesulfonyl -   NBS: N-bromosuccinimide -   PCC: Pyridinium chlorochromate -   PE: petroleum ether -   TFA: trifluoroacetic acid -   MMPP: magnesium monoperoxyphthalate -   HATU:     1-[Bis(dimethylamino)methylene]-1H-1,2,3-triazolo[4,5-b]pyridinium     3-oxide Hexafluorophosphate Cy: cyclohexyl -   Tol: toluene -   DMP: Dess-Martin periodinane -   IBX: 2-iodoxybenzoic acid -   PMB:p-methoxybenzyl -   SEM: [2-(Trimethylsilyl)ethoxy]methyl

1,3-DG (Int-2):

DMF (1 mL, 13.7 mmol) was added into a mixture of palmitic acid (433 g, 1.69 mol) in thionyl chloride (500 mL, 6.3 mol) at room temperature. The resultant reaction mixture was heated under reflux for 3 h. It was concentrated to dryness to afford palmitoyl chloride (453 g, 1.64 mol, 97% yield) as a yellowish oil, which was used in the next step without further purification.

To a mixture of 1,3-dihydroxypropan-2-one (77 g, 0.855 mol) and anhydrous pyridine (140 g, 1.76 mol) in anhydrous dichloromethane (2500 mL) under nitrogen at room temperature, was added with palmitic chloride (453 g, 1.64 mol). The mixture was stirred at room temperature for 16 h. It was diluted with MeOH (1000 mL) and water (2000 mL) and stirred for 30 min. The precipitate was collected by filter and dried to afford Int-1 (462 g, 0.815 mmol, 95% yield) as a white solid.

Int-1 (220 g, 388 mmol) was dissolved in a solution of THF (3000 mL) and water (200 mL) at 0° C. Sodium borohydride (22 g, 579 mmol) was added portion wise. After addition, the mixture was filtered to afford a cake, which was dried to afford compound Int-2 (1,3-DG) (177 g, 311 mmol, 80% yield) as a white solid. LC-MS: MS m/z=591 (M+Na+), RT=4.39 min; ¹H NMR (400 MHz, chloroform-d) δ 4.20-4.05 (m, 5H), 2.35 (t, J=7.6 Hz, 4H), 1.62 (t, J=7.6 Hz, 4H), 1.25 (s, 48H), 0.88 (t, J=6.6 Hz, 6H).

C5βMe-acid-2-TG (Int-4):

A mixture of 3-methylglutaric acid (500 mg, 3.42 mmol) and DMF (two drops) in thionyl chloride (2.48 mL, 34.2 mmol) was heated at reflux for two hours. The reaction was cooled to room temperature, diluted with toluene (5 mL) and concentrated under reduced pressure to give diacid chloride Int-3 (584 mg, 83%) as a yellow oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 3.02 (dd, J=17.3, 6.1 Hz, 2H), 2.89 (dd, J=17.3, 7.2 Hz, 2H), 2.61 (m, 1H), 1.13 (d, J=6.8 Hz, 2H).

A solution of Int-2 (1,3-DG) (50.0 mg, 0.0879 mmol) and pyridine (71.1 μL, 0.879 mmol) in dichloromethane (2 mL) was added to acid chloride Int-3 (80.4 mg, 0.439) in dichloromethane (1.5 mL) and the mixture heated at reflux for two hours. The reaction was cooled to room temperature, diluted with ethyl acetate (15 mL) and 1 M HCl (5 mL) and the organic phase separated. The aqueous layer was further extracted with ethyl acetate (2×20 mL) and the combined organic extracts washed with 1 M HCl (20 mL) and brine (2×30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (20% to 45% ethyl acetate/hexanes) gave Int-4 (54.0 mg, 88%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.27 (m, 1H), 4.311 (dd, J=11.9, 4.2 Hz, 1H), 4.305 (dd, J=11.9, 4.2 Hz, 1H), 4.14 (dd, J=11.9, 5.6 Hz, 2H), 2.52-2.39 (m, 3H), 2.36-2.24 (m, 6H), 1.66-1.55 (m, 4H), 1.37-1.17 (m, 48H), 1.06 (d, J=6.3 Hz, 3H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 178.1 (C), 173.5 (2C; C), 171.4 (C), 69.3 (CH), 62.2 (2C; CH₂), 40.7 (CH₂), 40.4 (CH₂), 34.1 (2C; CH₂), 32.1 (2C; CH₂), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.74 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 27.3 (CH), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.8 (CH₃), 14.2 (2C; CH₃); ESI-HRMS: calcd. for C₄₁H₇₆NaO₈ [M+Na⁺] 719.5432; found 719.5451.

Alternate Procedure (Larger Scale):

A mixture of 3-methylglutaric acid (100 g, 685 mmol) and acetyl chloride (250 mL, 3.53 mol) was heated under reflux for 16 h, then concentrated to dryness before adding into a solution of pyridine (270 g, 3.4 mol) and benzyl alcohol (100 g, 926 mmol) in dichloromethane (1500 mL) at room temperature. The mixture was stirred for 72 h. The reaction was concentrated and the residue was purified by silica column chromatography, eluting with from 0 to 50% ethyl acetate in petroleum ether to afford Int-6 (70 g, 297 mmol, 43% yield) as a yellowish oil. ¹H NMR (400 MHz, chloroform-d) δ 7.39-7.30 (m, 5H), 5.12 (s, 2H), 2.52-2.25 (m, 5H), 1.04 (d, J=6.6 Hz, 3H).

To a mixture of Int-6 (70 g, 297 mmol) and Int-2 (1,3-DG) (80 g, 140 mmol) in dichloromethane (1500 mL) was added EDCI (115 g, 600 mmol) and DMAP (3.66 g, 30 mmol). Triethylamine (100 mL, 719 mmol) was added drop wise at 0° C. The mixture was stirred at room temperature for 72 h. The reaction was concentrated to dryness and the residue was purified by silica column chromatography, eluting with ethyl acetate in petroleum ether from 0 to 50% to afford Int-7 (68 g, 86.5 mmol, 29% yield) as a white solid. ¹H NMR (400 MHz, chloroform-d) δ 7.40-7.32 (m, 5H), 5.30-5.24 (m, 1H), 5.12 (s, 2H), 4.31-4.27 (m, 2H), 4.17-4.10 (m, 2H), 2.50-2.38 (m, 3H), 2.34-2.28 (m, 6H), 1.61-1.55 (m, 4H), 1.35-1.20 (m, 48H), 1.02 (d, J=6.4 Hz, 3H), 0.88 (t, J=6.6 Hz, 6H).

Int-7 (68 g, 86.5 mmol) and palladium on carbon (3 g) were suspended in THF (400 mL). The mixture was hydrogenated under hydrogen atmosphere at 30° C. for 16 h, then filtered and concentrated to dryness. The residue was further purified by trituration with hexane to afford Int-4 (C5βMe-acid-2-TG) (51 g, 73.2 mmol, 84% yield) as a white solid. LC-MS: MS m/z=719 (M+Na+), RT=3.83 min. ¹H NMR (400 MHz, chloroform-d) δ 5.31-5.25 (m, 1H), 4.34-4.29 (m, 2H), 4.16-4.12 (m, 2H), 2.49-2.40 (m, 3H), 2.33-2.28 (m, 6H), 1.62-1.57 (m, 4H), 1.35-1.20 (m, 48H), 1.06 (d, J=6.4 Hz, 3H), 0.88 (t, J=6.6 Hz, 6H).

C10-acid-2-TG:

A mixture of sebacic acid (88.0 mg, 0.435 mmol) and DMF (one drop) in thionyl chloride (316 μL, 4.35 mmol) was heated at reflux for 1.5 hours. The reaction was cooled to RT, diluted with toluene (5 mL) and concentrated under reduced pressure to give diacid chloride Int-8 (104 mg, quant.) as a yellow oil that was used without purification. ¹H NMR (400 MHz, chloroform-d) δ 2.88 (t, J=7.3 Hz, 4H), 1.76-1.66 (m, 4H), 1.42-1.26 (m, 8H).

A solution of Int-2 (1,3-DG) (45.0 mg, 0.0791 mmol) and pyridine (64.0 μL, 0.791 mmol) in dichloromethane (1.5 mL) was added to diacid chloride Int-8 (104 mg, 0.435 mmol) in dichloromethane (1.5 mL) and the mixture stirred at rt for 1.5 hours. The reaction was diluted with ethyl acetate (5 mL), water (10 mL) and 1 M HCl (3 mL) and the aqueous layer extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with 1 M HCl (30 mL) and brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (20% to 50% ethyl acetate/hexanes) gave Int-9 (C10-acid-2-TG) (24.3 mg, 41%) as a pale yellow solid. ¹H NMR (400 MHz, CDCl₃) δ 5.26 (m, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 2.37-2.27 (m, 8H), 1.70-1.53 (m, 8H), 1.39-1.19 (m, 56H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 178.6 (C), 173.5 (2C; C), 173.0 (C), 69.0 (CH), 62.2 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 33.9 (CH₂), 32.01 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 29.2 (2C; CH₂), 29.11 (CH₂), 29.10 (CH₂), 25.00 (2C; CH₂), 24.95 (CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃).

Alternate Procedure (Larger Scale):

A mixture of sebacic acid (100 g, 495 mmol) and acetyl chloride (250 mL, 3.53 mol) was heated under reflux for 16 h, then cooled and concentrated to dryness. It was added into a solution of pyridine (270 g, 3.4 mol) and benzyl alcohol (100 g, 926 mmol) in dichloromethane (1500 mL) at room temperature and the mixture was stirred for 72 h. The reaction was concentrated and the residue was purified by column chromatography, eluting with from 0 to 50% ethyl acetate in petroleum ether to afford Int-11 (82 g, 281 mmol, 57% yield) as a yellowish oil. LC-MS: MS m/z=293 (M+H+), RT=1.45 min.

To a mixture of Int-11 (82 g, 281 mmol) and Int-2 (1,3-DG) (80 g, 140 mmol) in dichloromethane (1500 mL) was added EDCI (115 g, 600 mmol) and DMAP (3.66 g, 30 mmol). Then triethylamine (100 mL, 719 mmol) was added dropwise at 0° C. The mixture was stirred at room temperature for 72 h. The reaction was concentrated to dryness and the residue was purified by column chromatography, eluting with ethyl acetate in petroleum ether from 0 to 50% to afford Int-12 (65 g, 77 mmol, 27% yield) as a white solid. ¹H NMR (400 MHz, chloroform-d) δ 7.38-7.29 (m, 5H), 5.27-5.25 (m, 1H), 5.11 (s, 2H), 4.31-4.27 (m, 2H), 4.17-4.12 (m, 2H), 2.37-2.29 (m, 8H), 1.65-1.57 (m, 8H), 1.35-1.20 (m, 56H), 0.88 (t, J=6.6 Hz, 6H).

Int-12 (65 g, 77 mmol) and palladium on carbon (3 g) were suspended in THF (400 mL). The mixture was hydrogenated under hydrogen atmosphere at 30° C. for 16 h, then it was filtered and the filtrate concentrated to dryness and then further purified by trituration with hexane to afford Int-9 (C₁₀-acid-2-TG) (50 g, 66.4 mmol, 86% yield) as a white solid. LC-MS: MS m/z=775 (M+Na+), RT=5.95 min; ¹H NMR (400 MHz, chloroform-d) δ 5.29-5.24 (m, 1H), 4.31-4.27 (m, 2H), 4.19-4.12 (m, 2H), 2.37-2.39 (m, 8H), 1.65-1.58 (m, 8H), 1.35-1.20 (m, 56H), 0.88 (t, J=6.6 Hz, 6H).

Int-120 was Prepared Using Similar Methods:

¹H NMR (401 MHz, CDCl₃) δ 5.25 (m, 1H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.13 (dd, J=11.9, 5.9 Hz, 2H), 2.35-2.26 (m, 8H), 1.65-1.54 (m, 8H), 1.35-1.18 (m, 58H), 0.86 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 179.9 (C), 173.4 (2C; C), 173.0 (C), 69.0 (CH), 62.2 (2C; CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.0 (2C; CH₂), 29.81 (6C; CH₂), 29.77 (4C; CH₂), 29.74 (2C; CH₂), 29.59 (2C; CH₂), 29.48 (2C; CH₂), 29.38 (2C; CH₂), 29.36 (CH₂), 29.31 (2C; CH₂), 29.22 (2C; CH₂), 29.15 (CH₂), 29.13 (CH₂), 25.0 (3C; CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 14.2 (2C; CH₃). ESI-HRMS: calcd. for C₄₆H₈₆NaO₈ [M+Na⁺] 789.6215; found 789.6218.

C12α′βMe-acid-2-TG (Int-23 and Int-27):

Int-13: prepared according to: Young, I. S.; Kerr, M. A. J. Am. Chem. Soc. 2007, 129, 1465-1469.

Int-14: prepared according to: Chowdhury, R.; Ghosh, S. K. Org. Lett. 2009, 11, 3270-3273.

n-Butyllithium (n-BuLi, 1.6 M in hexanes, 765 μL, 1.23 mmol) was added slowly to a solution of TMS-acetylene (198 μL, 1.40 mmol) in THF (1.5 mL) at −78° C. and the mixture stirred at −78° C. for five minutes then warmed to rt and stirred for a further 15 minutes. The reaction was re-cooled to −50° C., a solution of bromide Int-14 (90.0 mg, 0.350 mmol) in THF (1 mL) was added dropwise and the mixture stirred at −50° C. for 15 minutes and then at room temperature for 17 hours. The reaction was diluted with brine (15 mL) and the aqueous phase extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave TMS alkyne Int-15 (45.9 mg, 48%) as a colorless oil also containing desilylated alkyne Int-16 (9.7 mg, 14% by ¹H NMR integration) and small amounts of PPh₃. ¹H NMR (400 MHz, CDCl₃) δ 7.37-7.26 (m, 5H), 4.50 (s, 2H), 3.48 (t, J=6.5 Hz, 2H), 2.23 (t, J=7.0 Hz, 2H), 1.68-1.60 (m, 2H), 1.58-1.42 (m, 4H), 0.14 (s, J=3.4 Hz, 7H).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 201 μL, 0.201 mmol) was added dropwise to a 7:2 mixture of silylalkyne Int-15 and alkyne Int-16 (55.6 mg combined, 0.215 mmol) in THF (1 mL) at 0° C. and the mixture stirred at room temperature for one hour. The reaction was diluted with water (5 mL) and sat. aq. NH₄Cl (3 mL) and the aqueous phase extracted with ethyl acetate (3×10 mL). The combined organic extracts were washed with brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (4% ethyl acetate/hexanes) gave alkyne Int-16 (37.5 mg, 53% over two steps) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.39-7.27 (m, 5H), 4.51 (s, 2H), 3.49 (t, J=6.5 Hz, 2H), 2.21 (td, J=6.9, 2.6 Hz, 2H), 1.95 (t, J=2.7 Hz, 1H), 1.70-1.61 (m, 2H), 1.60-1.48 (m, 4H); ¹³C NMR (101 MHz, CDCl₃) δ 138.7 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 84.6 (C), 73.0 (CH₂), 70.3 (CH₂), 68.4 (CH), 29.4 (CH₂), 28.4 (CH₂), 25.5 (CH₂), 18.5 (CH₂).

Int-17: prepared according to: Kim, H.-O. et al. Synlett 1998, 1059-1060.

A suspension of PdCl₂(PPh₃)₂ (16.8 mg, 0.0240 mmol) in DMF (1.5 mL) was degassed using N2 gas for five minutes, and then CuI (9.1 mg, 0.0480 mmol), Et₃N (66.8 μL, 0.480 mmol) and a degassed solution of alkyne Int-16 (48.5 mg, 0.240 mmol) and enol triflate Int-17 (94.3 mg, 0.360 mmol) in DMF (2 mL) were added. The mixture was degassed using a stream of N2 for a further five minutes and then heated at 0° C. for one hour. The reaction was cooled to room temperature, diluted with ethyl acetate (30 mL), washed with 1 M HCl, sat. aq. NaHCO₃, water and brine (20 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave enyne Int-18 (46.6 mg, 62%) as a pale yellow oil. ¹H NMR (400 MHz, CDCl₃) δ 7.37-7.24 (m, 5H), 5.92 (m, 1H), 4.50 (s, 2H), 4.17 (q, J=7.1 Hz, 2H), 3.48 (t, J=6.5 Hz, 2H), 2.45 (t, J=7.0 Hz, 2H), 2.01 (d, J=1.4 Hz, 3H), 1.69-1.59 (m, 4H), 1.56-1.49 (m, 2H), 1.27 (t, J=7.1 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 165.4 (C), 138.8 (C), 135.9 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 123.4 (CH), 102.9 (C), 80.0 (C), 73.0 (CH₂), 70.4 (CH₂), 60.0 (CH₂), 29.4 (CH₂), 28.4 (CH₂), 26.0 (CH₃), 25.7 (CH₂), 20.1 (CH₂), 14.4 (CH₃).

A solution of benzyl ether Int-18 (31.4 mg, 0.100 mmol) in ethyl acetate (8 mL) in a three-neck round-bottom flask was twice evacuated and flushed with N2 gas, then palladium on carbon (10% w/w, 26.6 mg, 0.0250 mmol) was added and the resulting suspension re-evacuated and flushed with N2 three times. The flask was fitted with a H2 balloon, evacuated and flushed with H2 three times and the reaction mixture stirred at RT under 1 atm of H2 for one hour. The flask was then evacuated and flushed with N2 and the reaction mixture filtered through a pad of Celite, washing with ethyl acetate (30 mL). The filtrate was concentrated under reduced pressure to give saturated alcohol Int-19 (23.0 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 4.12 (q, J=7.1 Hz, 2H), 3.63 (t, J=6.6 Hz, 2H), 2.28 (dd, J=14.6, 6.1 Hz, 1H), 2.09 (dd, J=14.6, 8.1 Hz, 1H), 1.94 (m, 1H), 1.60-1.50 (m, 2H), 1.25 (t, J=6.6 Hz, 3H), 1.40-1.13 (m, 10H), 0.92 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 63.2 (CH₂), 60.2 (CH₂), 42.1 (CH₂), 36.8 (CH₂), 32.9 (CH₂), 30.5 (CH), 29.8 (CH₂), 29.5 (CH₂), 26.9 (CH₂), 25.8 (CH₂), 19.9 (CH₃), 14.4 (CH₃).

Imidazole (9.6 mg, 0.141 mmol) and tert-butyl(chloro)diphenylsilane (TBDPSCl, 50.8 μL, 0.195 mmol) were added to a solution of alcohol Int-19 (18.0 mg, 0.0781 mmol) in DMF (3 mL) and the mixture stirred at RT for 16 hours. The reaction was diluted with ethyl acetate (20 mL), washed with brine (2×20 mL), dried (MgSO₄), and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (4% ethyl acetate/hexanes with 0.5% Et₃N) gave TBDPS ether Int-20 (33.7 mg, 92%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.70-7.64 (m, 4H), 7.45-7.33 (m, 6H), 4.13 (q, J=7.1 Hz, 2H), 3.65 (t, J=6.5 Hz, 2H), 2.28 (dd, J=14.6, 6.0 Hz, 1H), 2.09 (dd, J=14.6, 8.2 Hz, 1H), 1.94 (m, 1H), 1.60-1.50 (m, 2H), 1.38-1.21 (m, 3H), 1.05 (s, J=2.9 Hz, 2H), 1.05 (s, 9H), 0.93 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.1 (CH₂), 60.2 (CH₂), 42.1 (CH₂), 36.9 (CH₂), 32.7 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.5 (CH₂), 27.01 (3C; CH₃), 26.99 (CH₂), 25.9 (CH₂), 19.9 (CH₃), 19.4 (C), 14.4 (CH₃).

A solution of potassium hydroxide (2.0 M, 427 μL, 0.853 mmol) was added to ester Int-20 (40.0 mg, 0.0853 mmol) in ethanol (2 mL) and the mixture heated at 80° C. for two hours. The reaction was cooled to RT, acidified to pH 1 by addition of 1 M HCl and the organic solvent removed under reduced pressure. The residue was diluted with water (5 mL) and the aqueous phase extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give crude acid Int-21 (37.6 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 7.74-7.63 (m, 4H), 7.45-7.34 (m, 6H), 3.65 (t, J=6.5 Hz, 2H), 2.35 (dd, J=15.0, 5.9 Hz, 1H), 2.14 (dd, J=15.0, 8.2 Hz, 1H), 1.95 (m, 1H), 1.61-1.50 (m, 2H), 1.38-1.18 (m, 10H), 1.04 (s, 9H), 0.96 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 179.5 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.1 (CH₂), 41.7 (CH₂), 36.8 (CH₂), 32.7 (CH₂), 30.3 (CH), 29.8 (CH₂), 29.5 (CH₂), 27.01 (3C; CH₃), 26.97 (CH₂), 25.9 (CH₂), 19.8 (CH₃), 19.4 (C). Note: While two sets of signals were observed in both the ¹H and ¹³C NMR spectra, only the major set of signals are reported above. It was unclear if the doubling was due to the presence of two closely-related compounds or the presence of both monomeric and dimeric species due to the high concentration of the NMR sample.

DMAP (10.1 mg, 0.0831 mmol), EDC.HCl (39.8 mg, 0.208 mmol) and Int-2 (1,3-DG) (70.9 mg, 0.125 mmol) were added to a solution of acid Int-21 (36.6 mg, 0.0831 mmol) in dichloromethane (2.5 mL) and the mixture stirred at room temperature for 21 hours. The reaction was diluted with dichloromethane (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave triglyceride Int-22 (39.9 mg, 48% over two steps) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.69-7.64 (m, 4H), 7.44-7.34 (m, 6H), 5.28 (m, 1H), 4.289/4.287 (each dd, J=11.8, 4.2 Hz, 2H), 4.14 (dd, J=12.0, 5.9 Hz, 2H), 3.65 (t, J=6.5 Hz, 2H), 2.37-2.27 (m, 5H), 2.11 (dd, J=14.7, 8.4 Hz, 1H), 1.92 (m, 1H), 1.67-1.50 (m, 8H), 1.39-1.14 (m, 56H), 1.04 (s, 9H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 172.5 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 68.9 (CH), 64.1 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 32.7 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.54 (CH₂), 29.51 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.02 (CH₂), 27.00 (3C; CH₃), 25.9 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 19.4 (C), 14.3 (2C; CH₃).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 98.3 μL, 98.3 μmol) was added to a solution of TBDPS ether Int-22 (39.0 mg, 39.3 μmol) in THF (2.5 mL) at 0° C. and the mixture stirred at room temperature for three hours. The reaction was diluted with water (10 mL), extracted with ethyl acetate (3×15 mL), and the organic extracts washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave alcohol Int-23 (21.8 mg, 74%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.28 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.64 (t, J=6.6 Hz, 2H), 2.36-2.27 (m, 5H), 2.12 (dd, J=14.7, 8.2 Hz, 1H), 1.93 (m, 1H), 1.65-1.52 (m, 6H), 1.39-1.16 (m, 58H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 172.5 (C), 68.9 (CH), 63.2 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.7 (CH₂), 34.2 (2C; CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.84 (4C; CH₂), 29.83 (2C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (3C; CH₂), 29.4 (2C; CH₂), 29.3 (3C; CH₂), 26.9 (CH₂), 25.8 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.3 (2C; CH₃).

Pyridinium chlorochromate (PCC, 12.0 mg, 55.8 μmol) was added to a suspension of alcohol Int-23 (21.0 mg, 27.9 μmol) and celite (15 mg) in dichloromethane (1.5 mL) at 0° C. and the mixture stirred at room temperature for 1.75 hours. The reaction was filtered through a short pad of silica gel, eluting with ethyl acetate, and the filtrate concentrated under reduced pressure to give crude aldehyde Int-24 (20.9 mg, quant.) as a yellow oil that was used without purification.

¹H NMR (400 MHz, CDCl₃) δ 9.76 (s, 1H), 5.28 (m, 1H), 4.29 (dd, J=11.6, 3.5 Hz, 2H), 4.14 (dd, J=11.6, 5.7 Hz, 2H), 2.42 (t, J=7.1 Hz, 2H), 2.36-2.25 (m, 5H), 2.12 (dd, J=14.5, 8.3 Hz, 1H), 1.93 (m, 1H), 1.72-1.53 (m, 6H), 1.42-1.05 (m, 56H), 0.93 (d, J=6.5 Hz, 3H), 0.88 (t, J=6.6 Hz, 6H).

Int-25: prepared according to: Gossauer, A.; Kuhne, G. Liebigs. Ann. Chem. 1977, 664-686.

A solution of ylide Int-25 (8.1 mg, 19.0 μmol) in toluene (0.4 mL) was added to aldehyde Int-24 (11.0 mg, 14.6 μmol) in toluene (0.6 mL) and the mixture heated at reflux for four hours. The reaction was cooled to rt and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (5% to 10% ethyl acetate/hexanes) gave α,β-unsaturated benzyl ester Int-26 (7.1 mg, 54%) as a yellow oil. ¹H NMR (401 MHz, CDCl₃) δ 7.41-7.27 (m, 5H), 6.81 (td, J=7.5, 1.4 Hz, 1H), 5.27 (m, 1H), 5.18 (s, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.0 Hz, 2H), 2.36-2.27 (m, 5H), 2.20-2.08 (m, 3H), 1.93 (m, 1H), 1.85 (d, J=1.2 Hz, 3H), 1.67-1.54 (m, 6H), 1.47-1.38 (m, 2H), 1.37-1.19 (m, 54H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.4 (C), 168.2 (C), 143.2 (CH), 136.6 (C), 128.7 (2C; CH), 128.2 (CH), 128.1 (2C; CH), 127.6 (C), 69.0 (CH), 66.3 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.74 (CH₂), 29.63 (2C; CH₂), 29.56 (CH₂), 29.51 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.9 (CH₂), 28.7 (CH₂), 27.0 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₂), 14.3 (2C; CH₂), 12.6 (CH₂).

A solution of benzyl ether Int-26 (48.5 mg, 54.0 μmol) in ethyl acetate (2.5 mL) in a two-neck flask was evacuated and flushed with N2 gas (three times each), then palladium on carbon (10% w/w, 11.5 mg, 10.8 μmol) was added and the resulting suspension re-evacuated and flushed with N2 (three times each). The flask was fitted with a H2 balloon, evacuated and flushed with H2 (three times each) and the reaction mixture stirred at room temperature under 1 atm of H2 for three hours. The reaction was filtered through a pad of celite, washing with ethyl acetate, and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave saturated acid Int-27 (C12a′(3Me-acid-2-TG) (28.1 mg, 64%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.1 Hz, 2H), 2.46 (m, 1H), 2.37-2.26 (m, 5H), 2.12 (dd, J=14.7, 8.2 Hz, 1H), 1.94 (m, 1H), 1.73-1.55 (m, 5H), 1.41 (m, 1H), 1.37-1.20 (m, 60H), 1.18 (d, J=7.0 Hz, 3H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 182.3 (C), 173.5 (2C; C), 172.5 (C), 69.0 (CH), 62.3 (2C; CH₂), 41.8 (CH₂), 39.4 (CH), 36.8 (CH₂), 34.2 (2C; CH₂), 33.7 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (2C; CH₂), 29.60 (CH₂), 29.57 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.3 (CH₂), 27.0 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 17.0 (CH₃), 14.3 (2C; CH₃).

C₄-acid-2-TG (Int-28):

4-(Dimethylamino)pyridine (DMAP, 15.5 mg, 0.127 mmol) was added to a solution of 1,3-diglyceride Int-2 (72.2 mg, 0.127 mmol) and succinic anhydride (25.4 mg, 0.254 mmol) in pyridine/THF/CH₂Cl₂ (0.5 mL each) and the mixture stirred at room temperature for 17 hours. An extra portion of succinic anhydride (25.4 mg, 0.254 mmol) and DMAP (15.5 mg, 0.127 mmol) was added and the solution heated at 40° C. for a further 22 hours. The reaction was diluted with ethyl acetate (25 mL), washed with 1 M HCl (20 mL) and brine (2×30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% to 25% ethyl acetate/hexanes) gave acid-TG Int-28 (77.0 mg, 91%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.27 (m, 1H), 4.30 (dd, J=12.0, 4.3 Hz, 2H), 4.15 (dd, J=12.0, 5.8 Hz, 2H), 2.72-2.61 (m, 4H), 2.31 (t, J=7.6 Hz, 4H), 1.67-1.54 (m, 4H), 1.36-1.19 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 176.9 (C), 173.5 (2C; C), 171.4 (C), 69.8 (CH), 62.0 (2C; CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 29.0 (CH₂), 28.8 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃).

C₆-acid-2-TG (Int-29):

A solution of 1,3-diglyceride Int-2 (75.0 mg, 0.132 mmol) and pyridine (107 μL, 1.32 mmol) in CH₂Cl₂ (2.5 mL) was added to diacid chloride 1 (96.1 mL, 0.659 mmol) in CH₂Cl₂ (2.5 mL) and the mixture heated at reflux for 3.5 hours. The reaction was cooled to room temperature, diluted with ethyl acetate (30 mL) and the organic extract washed with 1 M HCl (20 mL) and brine (2×20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (15% to 25% ethyl acetate/hexanes) gave acid-TG Int-29 (52.7 mg, 57%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.26 (m, 1H), 4.30 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 2.41-2.34 (m, 4H), 2.31 (t, J=7.6 Hz, 4H), 1.72-1.65 (m, 4H), 1.65-1.56 (m, 4H), 1.35-1.20 (m, 48H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 178.3 (C), 173.5 (2C; C), 172.4 (C), 69.3 (CH), 62.2 (2C; CH₂), 34.2 (2C; CH₂), 33.8 (CH₂), 33.5 (CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.0 (2C; CH₂), 24.3 (CH₂), 24.1 (CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₂).

C10βMe-acid-2-TG (Int-30):

A solution of sodium chlorite (22.7 mg, 0.251 mmol) and sodium phosphate monobasic (NaH₂PO₄, 23.4 mg, 0.195 mmol) in water (1 mL) was added dropwise to aldehyde Int-24 (20.9 mg, 0.0279 mmol) in t-BuOH (1.5 mL) and 2,3-dimethyl-2-butene (0.3 mL) and the reaction stirred at room temperature for 2.25 hours. The reaction was diluted with water (10 mL) and the aqueous layer extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 20% ethyl acetate/hexanes with 0.5% acetic acid) gave acid Int-30 (16.1 mg, 75%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.27 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=12.0, 6.0 Hz, 2H), 2.37-2.27 (m, 7H), 2.12 (dd, J=14.7, 8.2 Hz, 1H), 1.93 (m, 1H), 1.67-1.55 (m, 6H), 1.40-1.14 (m, 56H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 179.7 (C), 173.5 (2C; C), 172.4 (C), 69.0 (CH), 62.3 (2C; CH₂), 41.8 (CH₂), 36.7 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.1 (2C; CH₂), 30.4 (CH), 29.82 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (3C; CH₂), 29.4 (2C; CH₂), 29.24 (2C; CH₂), 29.16 (CH₂), 26.8 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.2 (2C; CH₃).

Using similar methods to those described above, Int-121 was prepared:

¹H NMR (401 MHz, CDCl₃) δ 5.28 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.8, 6.0 Hz, 2H), 3.64 (t, J=6.6 Hz, 2H), 2.32 (dd, J=14.6, 5.8 Hz, 1H), 2.30 (t, J=7.5 Hz, 4H), 2.12 (dd, J=14.6, 8.2 Hz, 1H), 1.94 (m, 1H), 1.64-1.49 (m, 6H), 1.40-1.13 (m, 62H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.3 (2C; C), 172.4 (C), 68.9 (CH), 62.9 (CH₂), 62.2 (2C; CH₂), 41.7 (CH₂), 36.7 (CH₂), 34.1 (2C; CH₂), 32.9 (CH₂), 32.0 (2C; CH₂), 30.4 (CH), 29.80 (CH₂), 29.76 (6C; CH₂), 29.72 (4C; CH₂), 29.68 (2C; CH₂), 29.65 (CH₂), 29.62 (CH₂), 29.53 (2C; CH₂), 29.50 (CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 29.2 (2C; CH₂), 27.0 (CH₂), 25.8 (CH₂), 24.9 (2C; CH₂), 22.7 (2C; CH₂), 19.6 (CH₃), 14.2 (2C; CH₃).

C12-acid-2-TG (Int-37):

A mixture of dodecanedioic acid (700 mg, 3.04 mmol) and DMF (two drops) in thionyl chloride (2.20 mL, 30.4 mmol) was heated at reflux for two hours. The reaction was cooled to room temperature, diluted with toluene (5 mL) and concentrated under reduced pressure to give diacid chloride Int-36 (812 mg, quant.) as a yellow oil that was used without purification. ¹H NMR (400 MHz, CDCl₃): δ 2.88 (t, J=7.3 Hz, 4H), 1.76-1.65 (m, 4H), 1.42-1.23 (m, 12H).

A solution of 1,3-diglyceride Int-2 (40.0 mg, 0.0703 mmol) and pyridine (56.9 μL, 0.703 mmol) in CH₂Cl₂ (1.5 mL) was added to diacid chloride Int-36 (93.9 mg, 0.352 mmol) in CH₂Cl₂ (1.5 mL) and the mixture stirred at room temperature for 16 hours. The reaction was diluted with ethyl acetate (3 mL), water (10 mL) and 1 M HCl (2 mL) and the aqueous layer extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with 1 M HCl (30 mL) and brine (2×30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (20% to 45% ethyl acetate/hexanes) gave acid-TG Int-37 (30.7 mg, 56%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 5.26 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 2.38-2.26 (m, 8H), 1.69-1.54 (m, 8H), 1.38-1.19 (m, 60H), 0.87 (t, J=6.9 Hz, 6H).

C1513Me-acid-2-TG (Int-49):

A solution of 1,10-decanediol (1.05 g, 6.00 mmol) in DMF (7 mL) was added dropwise to a suspension of sodium hydride (60% w/w in mineral oil, washed twice with dry petrol, 240 mg, 6.00 mmol) in DMF (8 mL) at 0° C. and the mixture stirred at room temperature for one hour. Benzyl bromide (784 μL, 3.50 mmol) was added dropwise and the mixture stirred at room temperature for 1.5 hours. The reaction was diluted with ethyl acetate (30 mL), quenched with water (20 mL) and the aqueous phase extracted with ethyl acetate (3×30 mL). The combined organic extracts washed with water and brine (60 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (20% to 30% ethyl acetate/hexanes) gave benzyl ether Int-38 (657 mg, 41%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.39-7.24 (m, 5H), 4.50 (s, 2H), 3.64 (t, J=6.6 Hz, 2H), 3.46 (t, J=6.7 Hz, 2H), 1.65-1.52 (m, 4H), 1.40-1.25 (m, 12H).

Carbon tetrabromide (1.05 g, 3.17 mmol) and triphenylphosphine (1.07 g, 4.08 mmol) were added to a solution of alcohol Int-38 (600 mg, 1.11 mmol) in CH₂Cl₂ (20 mL) at 0° C. and the mixture stirred at room temperature for 2.5 hours. The reaction was diluted with CH₂Cl₂ (20 mL), silica gel was added and the solvent evaporated under reduced pressure. Purification by silica gel chromatography (3% to 4% ethyl acetate/hexanes) gave bromide Int-39 (658 mg, 89%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.41-7.26 (m, 5H), 4.50 (s, 2H), 3.46 (t, J=6.6 Hz, 2H), 3.40 (t, J=6.9 Hz, 2H), 1.91-1.79 (m, 2H), 1.68-1.56 (m, 2H), 1.47-1.23 (m, 12H).

n-Butyllithium (n-BuLi, 1.6 M in hexanes, 4.01 mL, 6.42 mmol) was added slowly to a solution of TMS-acetylene (1.02 mL, 7.22 mmol) in THF (9 mL) at −78° C. and the mixture stirred at −78° C. for five minutes then warmed to room temperature and stirred for a further 15 minutes. The reaction was re-cooled to −50° C., a solution of bromide Int-39 (525 mg, 1.60 mmol) and DMPU (1.06 mL, 8.82 mmol) in THF (6 mL) was added dropwise and the mixture stirred at −50° C. for 30 minutes and then at room temperature for 22 hours. The reaction was diluted with brine (15 mL) and the organic solvent evaporated under reduced pressure. The aqueous residue was extracted with ethyl acetate (3×25 mL) and the combined organic extracts washed with brine (50 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (3.5% to 4.5% ethyl acetate/hexanes) gave TMS alkyne Int-40 (489 mg, 88%) as a colorless oil containing small amounts of desilylated alkyne Int-41 (<10%). ¹H NMR (400 MHz, CDCl₃) δ 7.37-7.25 (m, 5H), 4.50 (s, 2H), 3.46 (t, J=6.7 Hz, 2H), 2.21 (t, J=7.2 Hz, 2H), 1.65-1.58 (m, 2H), 1.54-1.46 (m, 2H), 1.41-1.24 (m, 12H), 0.14 (s, 9H).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 1.61 mL, 1.61 mmol) was added dropwise to silylalkyne Int-40 (463 mg, 1.34 mmol) in THF (12 mL) at 0° C. and the mixture stirred at room temperature for 40 minutes. The reaction was diluted with water (10 mL) and the aqueous phase extracted with ethyl acetate (3×20 mL). The combined organic extracts were washed with brine (40 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave alkyne Int-41 (361 mg, 98%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.38-7.25 (m, 5H), 4.50 (s, 2H), 3.46 (t, J=6.7 Hz, 2H), 2.18 (td, J=7.1, 2.6 Hz, 2H), 1.94 (t, J=2.7 Hz, 1H), 1.65-1.57 (m, 2H), 1.55-1.48 (m, 2H), 1.43-1.24 (m, 12H). ¹³C NMR (101 MHz, CDCl₃) δ 138.86 (C), 128.49 (2C; CH), 127.77 (2C; CH), 127.61 (CH), 84.97 (C), 73.00 (CH₂), 70.67 (CH₂), 68.18 (CH), 29.91 (CH₂), 29.67 (CH₂), 29.59 (CH₂), 29.57 (CH₂), 29.23 (CH₂), 28.89 (CH₂), 28.63 (CH₂), 26.33 (CH₂), 18.54 (CH₂).

A suspension of PdCl₂(PPh₃)₂ (32.2 mg, 0.0459 mmol) in DMF (4 mL) was degassed using a stream of N2 gas for five minutes, and then CuI (35.0 mg, 0.184 mmol), Et₃N (256 μL, 1.84 mmol) and a degassed solution of alkyne Int-41 (250 mg, 0.918 mmol) and enol triflate Int-17 (313 mg, 1.19 mmol) in DMF (6 mL) were added. The mixture was degassed using a stream of N2 for a further five minutes and then heated at 70° C. for one hour. The reaction was cooled to room temperature, diluted with ethyl acetate (40 mL), washed with 1 M HCl, sat. aq. NaHCO₃, water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave enyne Int-42 (269 mg, 76%) as a pale yellow oil. ¹H NMR (400 MHz, CDCl₃) δ 7.38-7.24 (m, 5H), 5.92 (m, 1H), 4.50 (s, 2H), 4.18 (t, J=7.1 Hz, 2H), 3.46 (t, J=6.7 Hz, 2H), 2.43 (t, J=7.2 Hz, 2H), 2.01 (d, J=1.4 Hz, 3H), 1.65-1.55 (m, 4H), 1.46-1.24 (m, 12H); ¹³C NMR (101 MHz, CDCl₃) δ 165.4 (C), 138.8 (C), 135.9 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 123.3 (CH), 103.3 (C), 79.9 (C), 73.0 (CH₂), 70.6 (CH₂), 60.0 (CH₂), 29.9 (CH₂), 29.65 (CH₂), 29.59 (CH₂), 29.56 (CH₂), 29.2 (CH₂), 29.1 (CH₂), 28.6 (CH₂), 26.3 (CH₂), 26.0 (CH₃), 20.1 (CH₂), 14.4 (CH₃).

A solution of benzyl ether Int-42 (246 mg, 0.640 mmol) in ethyl acetate (25 mL) in a three-neck round-bottom flask was twice evacuated and flushed with N2 gas, then palladium on carbon (10% w/w, 102 mg, 0.0960 mmol) was added and the resulting suspension re-evacuated and flushed with N2 three times. The flask was fitted with a H2 balloon, evacuated and flushed with H2 three times and the reaction mixture stirred at room temperature under 1 atm of H2 for one hour. The reaction mixture was then filtered through a pad of celite and the pad washed with ethyl acetate (40 mL). The filtrate was concentrated under reduced pressure to give saturated alcohol Int-43 (192 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 4.12 (q, J=7.1 Hz, 2H), 3.63 (t, J=6.6 Hz, 2H), 2.28 (dd, J=14.6, 6.0 Hz, 1H), 2.08 (dd, J=14.6, 8.1 Hz, 1H), 1.93 (m, 1H), 1.60-1.51 (m, 2H), 1.43-1.12 (m, 23H), 0.92 (d, J=6.6 Hz, 3H). ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 63.2 (CH₂), 60.2 (CH₂), 42.1 (CH₂), 36.9 (CH₂), 32.9 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.74 (4C; CH₂), 29.70 (CH₂), 29.6 (CH₂), 27.0 (CH₂), 25.9 (CH₂), 19.9 (CH₃), 14.4 (CH₃).

Imidazole (32.0 mg, 0.0.469 mmol) and tert-butyl(chloro)diphenylsilane (TBDPSCl, 183 μL, 0.704 mmol) were added to a solution of alcohol Int-43 (70.5 mg, 0.235 mmol) in DMF (7 mL) and the mixture stirred at room temperature for 17 hours. The reaction was diluted with ethyl acetate (20 mL), washed with water (20 mL) and brine (2×20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (3% to 4% ethyl acetate/hexanes with 0.5% Et₃N) gave TBDPS ether Int-44 (117 mg, 93%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 7.70-7.63 (m, 4H), 7.44-7.34 (m, 6H), 4.12 (q, J=7.1 Hz, 2H), 3.65 (t, J=6.5 Hz, 2H), 2.29 (dd, J=14.6, 6.0 Hz, 1H), 2.09 (dd, J=14.6, 8.2 Hz, 1H), 1.95 (m, 1H), 1.60-1.50 (m, 2H), 1.38-1.14 (m, 23H), 1.04 (s, J=2.8 Hz, 9H), 0.92 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.1 (CH₂), 60.2 (CH₂), 42.1 (CH₂), 36.9 (CH₂), 32.7 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.79 (3C; CH₂), 29.77 (2C; CH₂), 29.5 (CH₂), 27.1 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 19.9 (CH₃), 19.4 (C), 14.4 (CH₃).

A solution of potassium hydroxide (2.0 M, 390 μL, 0.781 mmol) was added to ester Int-44 (42.1 mg. 0.0781 mmol) in ethanol (2 mL) and the mixture heated at 60° C. for 1.5 hours. The reaction was acidified to pH 1 by addition of 1 M HCl, diluted with water (10 mL) and the aqueous phase extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give crude acid Int-45 (39.9 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 7.75-7.66 (m, 4H), 7.46-7.35 (m, 6H), 3.67 (t, J=6.5 Hz, 2H), 2.36 (dd, J=15.0, 5.9 Hz, 1H), 2.15 (dd, J=14.9, 8.2 Hz, 1H), 1.97 (m, 1H), 1.61-1.52 (m, 2H), 1.41-1.17 (m, 20H), 1.06 (s, 9H), 0.98 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 179.7 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.2 (CH₂), 41.7 (CH₂), 36.8 (CH₂), 32.7 (CH₂), 30.3 (CH), 29.9 (CH₂), 29.80 (2C; CH₂), 29.78 (2C; CH₂), 29.75 (CH₂), 29.5 (CH₂), 27.1 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 19.8 (CH₃), 19.4 (C).

4-(Dimethylamino)pyridine (DMAP, 9.5 mg, 0.0781 mmol), EDC.HCl (29.9 mg, 0.156 mmol) and 1,3-diglyceride Int-2 (53.3 mg, 0.0937 mmol) were added to a solution of acid Int-45 (39.9 mg, 0.0781 mmol) in CH₂Cl₂ (2.5 mL) and the mixture stirred at room temperature for 19 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave triglyceride Int-46 (72.8 mg, 88% over two steps) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.73-7.63 (m, 4H), 7.49-7.31 (m, 6H), 5.29 (m, 1H), 4.30 (dd, J=11.9, 4.2 Hz, 2H), 4.15 (dd, J=11.9, 6.1 Hz, 2H), 3.66 (t, J=6.5 Hz, 2H), 2.34 (dd, J=14.6, 6.0 Hz, 1H), 2.31 (t, J=7.5 Hz, 4H), 2.13 (dd, J=14.6, 8.3 Hz, 1H), 1.94 (m, 1H), 1.68-1.52 (m, 6H), 1.44-1.16 (m, 68H), 1.05 (s, 9H), 0.94 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.5 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 68.9 (CH), 64.1 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 32.7 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 30.0 (CH₂), 29.84 (8C; CH₂), 29.80 (6C; CH₂), 29.76 (2C; CH₂), 29.61 (2C; CH₂), 29.54 (CH₂), 29.50 (3C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.2 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 19.3 (C), 14.3 (2C; CH₃).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 186 μL, 0.186 mmol) and acetic acid (10.6 μL, 0.186 mmol) were added dropwise to TBDPS ether Int-46 (65.7 mg, 0.0619 mmol) in THF (3 mL) at 0° C. and the mixture stirred at room temperature for 19 hours. The reaction was diluted with water (10 mL) and the aqueous phase extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with sat. aq. NaHCO₃ and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 15% ethyl acetate/hexanes) gave alcohol Int-47 (34.2 mg, 67%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 5.27 (m, 1H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.8, 6.0 Hz, 2H), 3.63 (t, J=6.6 Hz, 2H), 2.32 (dd, J=14.6, 5.9 Hz, 1H), 2.30 (t, J=7.6 Hz, 4H), 2.11 (dd, J=14.6, 8.3 Hz, 1H), 1.92 (m, 1H), 1.66-1.52 (m, 6H), 1.40-1.13 (m, 68H), 0.92 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 172.5 (C), 68.9 (CH), 63.2 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (8C; CH₂), 29.80 (6C; CH₂), 29.76 (2C; CH₂), 29.73 (CH₂), 29.62 (2C; CH₂), 29.57 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.1 (CH₂), 25.9 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.3 (2C; CH₃).

Pyridinium chlorochromate (PCC, 14.7 mg, 68.0 μmol) was added to a suspension of alcohol Int-47 (28.0 mg, 34.0 μmol) and celite (15 mg) in CH₂Cl₂ (1.5 mL) at 0° C. and the mixture stirred at room temperature for one hour. The reaction was filtered through a short pad of silica gel, eluting with ethyl acetate, and the filtrate concentrated under reduced pressure to give crude aldehyde Int-48 (27.9 mg, quant.) as a yellow oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 9.76 (s, 1H), 5.28 (m, 1H), 4.29 (dd, J=11.6, 3.5 Hz, 2H), 4.14 (dd, J=11.9, 5.8 Hz, 2H), 2.42 (t, J=6.8 Hz, 2H), 2.36-2.25 (m, 5H), 2.12 (dd, J=14.4, 8.5 Hz, 1H), 1.94 (m, 1H), 1.69-1.51 (m, 6H), 1.42-1.09 (m, 66H), 0.93 (d, J=6.4 Hz, 3H), 0.88 (t, J=6.3 Hz, 6H).

A solution of sodium chlorite (27.6 mg, 0.306 mmol) and sodium phosphate monobasic (NaH₂PO₄, 28.8 mg, 0.238 mmol) in water (1.2 mL) was added dropwise to aldehyde Int-48 (27.9 mg, 0.0340 mmol) in t-BuOH (1.8 mL) and 2,3-dimethyl-2-butene (0.4 mL) and the reaction stirred at room temperature for 16 hours. The reaction was acidified to pH 2 using 1 M HCl, diluted with water (10 mL) and the aqueous layer extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with brine (30 mL), dried ((MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 15% ethyl acetate/hexanes with 0.5% acetic acid) gave acid Int-49 (24.3 mg, 85%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.29 (m, 1H), 4.29 (dd, J=11.9, 3.8 Hz, 2H), 4.14 (dd, J=11.9, 6.1 Hz, 2H), 2.37-2.27 (m, 7H), 2.11 (dd, J=14.7, 8.3 Hz, 1H), 1.92 (m, 1H), 1.68-1.54 (m, 6H), 1.40-1.13 (m, 66H), 0.93 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 179.5 (C), 173.5 (2C; C), 172.5 (C), 68.9 (CH), 62.3 (2C; CH₂), 41.9 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.93 (CH₂), 29.85 (8C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.73 (CH₂), 29.62 (2C; CH₂), 29.58 (CH₂), 29.51 (2C; CH₂), 29.42 (2C; CH₂), 29.39 (CH₂), 29.26 (2C; CH₂), 29.2 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 19.7 (CH₂), 14.3 (2C; CH₂).

Using similar methods, Int-118 was prepared from 1,8-octanediol:

¹H NMR (400 MHz, CDCl₃) δ 5.31 (s, 1H), 4.33 (dd, J=8.4, 4.4 Hz, 2H), 4.19 (dd, J=11.8, 5.9 Hz, 2H), 2.47 (m, 1H), 2.37 (dt, J=15.6, 7.4 Hz, 6H), 1.65 (s, 7H), 1.31 (d, J=13.3 Hz, 58H), 1.18 (d, J=6.9 Hz, 3H), 0.92 (t, J=6.6 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 179.73 (1C), 175.87 (1C), 173.31 (2C), 68.70 (1C), 62.13 (1C), 39.50 (1C), 34.04 (3C), 33.57 (1C), 31.93 (4C), 29.71-29.01 (18C), 27.07 (1C), 24.85 (3C), 24.62 (1C), 22.70 (4C), 17.03 (1C), 14.14 (3C). MASS (ESI, −ve) m/z: 766.0 (M−1). (ESI, +ve) m/z: 785.0 (M+18).

C15α′βMe-acid-2-TG (Int-62):

Int-50: prepared according to: Subba Reddy, B. V. et al. Helv. Chim. Acta. 2013, 96, 1983-1990.

Int-51: known compound that may be prepared as disclosed in Takagi, Y. et al. Tetrahedron: Asymm. 2004, 15, 2591-2594). ¹H NMR (401 MHz, CDCl₃) δ 7.39-7.23 (m, 5H), 4.50 (s, 2H), 3.47 (t, J=6.6 Hz, 2H), 3.40 (t, J=6.9 Hz, 2H), 1.90-1.80 (m, 2H), 1.66-1.57 (m, 2H), 1.48-1.26 (m, 8H).

n-Butyllithium (n-BuLi, 2.0 M in cyclohexane, 18.1 mL, 36.3 mmol) was added slowly to a solution of TMS-acetylene (5.7 mL, 41.5 mmol) in THF (45 mL) at −78° C. and the mixture stirred at −78° C. for five minutes then warmed to room temperature and stirred for a further 15 minutes. The reaction was re-cooled to −78° C., a solution of bromide Int-51 (3.10 g, 10.4 mmol) and DMPU (6.3 mL, 51.8 mmol) in THF (30 mL) was added slowly and the mixture stirred at −78° C. for 30 minutes and then at room temperature for 18 hours. The reaction was diluted with water (60 mL) and the majority of the organic solvent removed under reduced pressure. The residue was diluted with brine (120 mL) and the aqueous phase extracted with ethyl acetate (3×100 mL). The combined organic extracts were washed with brine (3×100 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (Reveleris 80 g column, 60 mL/min, 4% to 40% ethyl acetate/hexanes) gave TMS alkyne Int-52 (3.05 g, 93%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 7.36-7.25 (m, 5H), 4.50 (s, 2H), 3.46 (t, J=6.6 Hz, 2H), 2.21 (t, J=7.2 Hz, 2H), 1.65-1.57 (m, 2H), 1.55-1.46 (m, 2H), 1.41-1.27 (m, 8H), 0.15 (s, 9H).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 9.7 mL, 9.70 mmol) was added dropwise to silylalkyne Int-52 (3.05 g, 9.62 mmol) in THF (40 mL) at 0° C. and the mixture stirred at room temperature for one hour. The reaction was diluted with water (25 mL) and the organic solvent removed under reduced pressure. The resulting solution was diluted with brine (100 mL) and the aqueous phase extracted with ethyl acetate (3×50 mL). The combined organic extracts were washed with brine (3×50 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (Reveleris 80 g column, 60 mL/min, 3% to 10% ethyl acetate/hexanes) gave alkyne Int-53 (2.17 g, 92%). ¹H NMR (401 MHz, CDCl₃) δ 7.38-7.25 (m, 5H), 4.50 (s, 2H), 3.46 (t, J=6.6 Hz, 2H), 2.18 (td, J=7.1, 2.6 Hz, 2H), 1.94 (t, J=2.7 Hz, 1H), 1.66-1.56 (m, 2H), 1.57-1.48 (m, 2H), 1.43-1.27 (m, 8H); ¹³C NMR (101 MHz, CDCl₃) δ 138.8 (C), 128.4 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 84.8 (C), 73.0 (CH), 70.6 (CH₂), 68.2 (CH), 29.8 (CH₂), 29.4 (CH₂), 29.1 (CH₂), 28.8 (CH₂), 28.6 (CH₂), 26.2 (CH₂), 18.5 (CH₂).

Int-17 was prepared as described above.

A suspension of PdCl₂(PPh3)₂ (605 mg, 0.862 mmol) in DMF (40 mL) was degassed using N2 gas for five minutes, and then CuI (335 mg, 1.76 mmol), Et₃N (2.40 mL, 17.2 mmol) and a degassed solution of alkyne 4 (2.11 g, 8.62 mmol) and enol triflate Int-17 (3.40 g, 13.00 mmol) in DMF (50 mL) were added. The mixture was degassed using a stream of N2 for a further five minutes and then heated at 70° C. for one hour. The reaction was cooled to room temperature and concentrated under reduced pressure to about one-quarter of its original volume. The resulting solution was diluted with ethyl acetate (80 mL), washed with 1 M HCl, sat. aq. NaHCO₃, water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (Reveleris 80 g column, 60 mL/min, 5% to 20% ethyl acetate/hexanes) gave enyne Int-54 (2.35 g, 76%) as a pale yellow oil. ¹H NMR (401 MHz, CDCl₃) δ 7.37-7.24 (m, 5H), 5.92 (d, J=1.4 Hz, 1H), 4.50 (s, 2H), 4.18 (q, J=7.1 Hz, 2H), 3.46 (t, J=6.6 Hz, 2H), 2.43 (t, J=7.2 Hz, 2H), 2.01 (d, J=1.4 Hz, 3H), 1.65-1.55 (m, 4H), 1.46-1.30 (m, 8H), 1.28 (t, J=7.1 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 165.4 (C), 138.8 (C), 135.9 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 123.4 (CH), 103.2 (C), 79.9 (C), 73.0 (CH₂), 70.6 (CH₂), 60.0 (CH₂), 29.9 (CH₂), 29.4 (CH₂), 29.2 (CH₂), 29.0 (CH₂), 28.6 (CH₂), 26.3 (CH₂), 26.0 (CH₃), 20.1 (CH₂), 14.4 (CH₃).

A solution of benzyl ether Int-54 (707 mg, 1.98 mmol) in ethyl acetate (80 mL) in a three-neck round-bottom flask was twice evacuated and flushed with N2 gas, then palladium on carbon (10% w/w, 525 mg, 0.494 mmol) was added and the resulting suspension re-evacuated and flushed with N2 three times. The flask was fitted with a H2 balloon, evacuated and flushed with H2 three times and the reaction mixture stirred at room temperature under 1 atm of H2 for two hours. The flask was then evacuated and flushed with N2 and the reaction mixture filtered through a pad of celite, washing with ethyl acetate (80 mL). The filtrate was concentrated under reduced pressure to give saturated alcohol Int-55 (540 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (401 MHz, CDCl₃) δ 4.13 (q, J=7.1 Hz, 2H), 3.64 (t, J=6.6 Hz, 2H), 2.28 (dd, J=14.6, 6.0 Hz, 1H), 2.09 (dd, J=14.6, 8.1 Hz, 1H), 1.94 (m, 1H), 1.62-1.51 (m, 2H), 1.39-1.21 (m, 16H), 1.25 (t, J=7.1 Hz, 3H), 0.93 (d, J=6.6 Hz, 3H).

Imidazole (670 mg, 9.85 mmol) and tert-butyl(chloro)diphenylsilane (TBDPSCl, 3.5 mL, 13.6 mmol) were added to a solution of alcohol Int-55 (1.48 g, 5.42 mmol) in CH₂Cl₂ (80 mL) at 0° C. and the mixture stirred at room temperature for 2.5 hours. The reaction was concentrated to half its volume under reduced pressure, washed with water (2×20 mL) and brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (Reveleris 80 g column, 60 mL/min, 1% to 16% ethyl acetate/hexanes) gave TBDPS ether Int-56 (2.46 g, 89%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 7.75-7.64 (m, 4H), 7.46-7.35 (m, 6H), 4.13 (q, J=7.1 Hz, 2H), 3.65 (t, J=6.5 Hz, 2H), 2.29 (dd, J=14.6, 6.0 Hz, 1H), 2.09 (dd, J=14.6, 8.2 Hz, 1H), 1.95 (m, 1H), 1.61-1.50 (m, 2H), 1.38-1.20 (m, 19H), 1.05 (s, 9H), 0.93 (d, J=6.6 Hz, 3H).

A solution of potassium hydroxide (2.0 M, 11.3 mL, 22.6 mmol) was added to ester Int-56 (1.15 g, 2.26 mmol) in ethanol (40 mL) and the mixture stirred at room temperature for 19 hours. The reaction was adjusted to pH 2 by addition of 1 M HCl and the organic solvent removed under reduced pressure. The residue was diluted with water (15 mL) and the aqueous phase extracted with ethyl acetate (3×20 mL). The combined organic extracts were washed with brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (5% to 25% ethyl acetate/hexanes) gave a pure sample of acid Int-57 (321 mg, 29%) as a pale yellow oil that was used for analytical purposes. An additional >750 mg of 9 was obtained containing slight contamination by an unknown TBDPS species—this material was carried forward and purified at a later stage in the reaction sequence. ¹H NMR (401 MHz, CDCl₃) δ 7.70-7.64 (m, 4H), 7.44-7.34 (m, 6H), 3.65 (t, J=6.5 Hz, 2H), 2.35 (dd, J=15.0, 5.9 Hz, 1H), 2.14 (dd, J=15.0, 8.2 Hz, 1H), 1.95 (m, 1H), 1.60-1.51 (m, 2H), 1.39-1.16 (m, 16H), 1.04 (s, 9H), 0.96 (d, J=6.6 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 179.3 (C), 135.7 (4C; CH), 134.4 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.2 (CH₂), 41.7 (CH₂), 36.8 (CH₂), 32.7 (CH₂), 30.3 (CH), 29.9 (CH₂), 29.76 (2C; CH₂), 29.72 (CH₂), 29.5 (CH₂), 27.1 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 19.8 (CH₃), 19.4 (C).

DMAP (80.8 mg, 0.661 mmol), EDC.HCl (230 mg, 1.20 mmol) and 1,3-diglyceride Int-2 (374 mg, 0.658 mmol) were added to a solution of acid Int-57 (288 mg, 0.597 mmol) in CH₂Cl₂ (20 mL) and the mixture stirred at room temperature for 20 hours. The reaction was diluted with CH₂Cl₂ (20 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (5% to 8% ethyl acetate/hexanes) gave triglyceride Int-58 (416 mg, 67%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.69-7.64 (m, 4H), 7.44-7.34 (m, 6H), 5.28 (m, 1H), 4.289/4.288 (each dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=12.0, 6.0 Hz, 2H), 3.65 (t, J=6.5 Hz, 2H), 2.34 (dd, J=15.0, 5.9 Hz, 1H), 2.30 (t, J=7.5 Hz, 4H), 2.12 (dd, J=14.6, 8.3 Hz, 1H), 1.93 (m, 1H), 1.66-1.50 (m, 6H), 1.45-1.14 (m, 64H), 1.04 (s, 9H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.6 Hz, 6H).

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 574 μL, 0.574 mmol) and acetic acid (32.8 μL, 0.574 mmol) were added to a solution of TBDPS ether Int-58 (395 mg, 0.383 mmol) in THF (15 mL) at 0° C. and the mixture stirred at room temperature for 17 hours. The reaction was concentrated under reduced pressure and the residue diluted with ethyl acetate (30 mL), washed with water (2×20 mL) and brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (5% to 25% ethyl acetate/hexanes) gave alcohol Int-59 (282 mg, 93%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 5.28 (m, 1H), 4.286/4.285 (each dd, J=11.8, 4.2 Hz, 2H), 4.14 (dd, J=11.9, 5.7 Hz, 2H), 3.63 (t, J=6.6 Hz, 2H), 2.33 (dd, J=15.0, 5.9 Hz, 1H), 2.30 (t, J=7.5 Hz, 4H), 2.12 (dd, J=14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.68-1.52 (m, 6H), 1.49-1.15 (m, 64H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.6 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 172.5 (C), 69.0 (CH), 63.2 (CH₂), 62.3 (2C; CH₂), 41.9 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 33.0 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.74 (CH₂), 29.71 (CH₂), 29.62 (2C; CH₂), 29.57 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (3C; CH₂), 27.1 (CH₂), 25.9 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.3 (2C; CH₃).

Pyridinium chlorochromate (PCC, 143 mg, 0.664 mmol) was added to a suspension of alcohol Int-59 (263 mg, 0.331 mmol) and Celite (150 mg) in CH₂Cl₂ (18 mL) at 0° C. and the mixture stirred at room temperature for four hours. The reaction was filtered through a short pad of silica gel, eluting with ethyl acetate, and the filtrate concentrated under reduced pressure to give crude aldehyde Int-60 (262 mg, quant.) as a yellow oil that was used without purification. ¹H NMR (401 MHz, CDCl₃) δ 9.76 (t, J=1.8 Hz, 1H), 5.27 (m, 1H), 4.29 (dd, J=11.8, 4.1 Hz, 2H), 4.14 (dd, J=11.8, 6.0 Hz, 2H), 2.42 (td, J=7.4, 1.8 Hz, 2H), 2.33 (dd, J=15.0, 5.9 Hz, 1H), 2.30 (t, J=7.5 Hz, 4H), 2.12 (dd, J=14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.69-1.53 (m, 6H), 1.45-1.16 (m, 62H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.8 Hz, 6H).

Int-25 was prepared as described above.

A solution of ylide Int-25 (270 mg, 0.637 mmol) in toluene (10 mL) was added to aldehyde Int-60 (262 mg, 0.331 mmol) in toluene (8 mL) and the mixture heated at reflux for 20 hours. The reaction was cooled to room temperature and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (5% to 15% ethyl acetate/hexanes) gave α,β-unsaturated benzyl ester Int-61 (273 mg, 88%) as a yellow oil. ¹H NMR (401 MHz, CDCl₃) δ 7.40-7.27 (m, 5H), 6.82 (td, J=7.5, 1.4 Hz, 1H), 5.28 (m, 1H), 5.18 (s, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.0 Hz, 2H), 2.33 (dd, J=15.0, 5.9 Hz, 1H), 2.30 (t, J=7.5 Hz, 4H), 2.20-2.07 (m, 3H), 1.92 (m, 1H), 1.85 (d, J=1.2 Hz, 3H), 1.65-1.53 (m, 4H), 1.47-1.37 (m, 2H), 1.36-1.14 (m, 62H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.5 (C), 168.2 (C), 143.3 (CH), 136.6 (C), 128.6 (2C; CH), 128.13 (CH), 128.11 (2C; CH), 127.5 (C), 68.9 (CH), 66.3 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.70 (CH₂), 29.61 (3C; CH₂), 29.57 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (3C; CH₂), 28.9 (CH₂), 28.7 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.3 (2C; CH₃), 12.5 (CH₃).

A solution of benzyl ester Int-61 (246 mg, 0.262 mmol) in ethyl acetate (10 mL) in a two-neck flask was evacuated and flushed with N2 gas (three times each), then palladium on carbon (10% w/w, 55.7 mg, 0.0524 mmol) was added and the resulting suspension re-evacuated and flushed with N2 (three times each). The flask was fitted with a H2 balloon, evacuated and flushed with H2 (three times each) and the reaction mixture stirred at room temperature under 1 atm of H2 for 1.5 hours. The reaction was filtered through a pad of celite, washing with ethyl acetate, and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (5% to 20% ethyl acetate/hexanes) gave saturated acid Int-62 (193 mg, 87%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 5.28 (m, 1H), 4.291/4.289 (each dd, J=11.8, 4.2 Hz, 2H), 4.147/4.144 (each dd, J=11.9, 6.0 Hz, 2H), 2.46 (m, 1H), 2.33 (dd, J=15.0, 5.9 Hz, 1H), 2.31 (t, J=7.5 Hz, 4H), 2.12 (dd, J=14.7, 8.2 Hz, 1H), 1.94 (m, 1H), 1.73-1.55 (m, 5H), 1.50-1.21 (m, 67H), 1.18 (d, J=7.0 Hz, 3H), 0.93 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H).

Ph-C₃-phenol-2-TG (Int-67):

DBU (108 μL, 1.08 mmol) and t-butyldiphenylsilyl chloride (TBDPSCl, 338 μL, 1.30 mmol) were added to a solution of (4-hydroxyphenyl)propionic acid (Int-63; commercially available) (120 mg, 0.722 mmol) in DMF (4 mL) and the mixture stirred at room temperature for one hour. The reaction was diluted with ethyl acetate (15 mL) and organic phase washed with water and brine (15 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (4.5% ethyl acetate/hexanes) gave silyl ester Int-64 (165 mg, 36%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 7.75-7.70 (m, 4H), 7.63-7.58 (m, 4H), 7.46-7.31 (m, 12H), 6.97-6.91 (m, 2H), 6.71-6.67 (m, 2H), 2.87 (t, J=7.6 Hz, 2H), 2.72 (t, J=7.6 Hz, 2H), 1.11 (s, 9H), 1.07 (s, 9H); ¹³C NMR (101 MHz, CDCl₃): δ 172.3 (C), 154.1 (C), 135.7 (4C; CH), 135.4 (4C; CH), 133.2 (2C; C), 133.0 (C), 132.0 (2C; C), 130.1 (2C; CH), 130.0 (2C; CH), 129.2 (2C; CH), 127.9 (4C; CH), 127.8 (4C; CH), 119.7 (2C; CH), 37.9 (CH₂), 30.4 (CH₂), 27.0 (3C; CH₃), 26.7 (3C; CH₃), 19.6 (C), 19.2 (C).

Potassium carbonate (157 mg, 1.14 mmol) was added to a solution of TBDPS ester Int-64 (147 mg, 0.228 mmol) in THF (3 mL), methanol (1.5 mL) and water (1.5 mmol) and the mixture stirred at room temperature for 2.5 hours. The reaction was acidified to pH 2 by the addition of 1 M HCl and the aqueous layer extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with water (30 mL), sat. aq. NaHCO₃ (30 mL) and brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (20% to 35% to 50% ethyl acetate/hexanes) gave acid Int-65 (82.4 mg, 89%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.74-7.67 (m, 4H), 7.45-7.32 (m, 6H), 6.95-6.88 (m, 2H), 6.71-6.65 (m, 2H), 2.82 (t, J=7.8 Hz, 2H), 2.58 (t, J=7.8 Hz, 2H), 1.09 (s, 9H); ¹³C NMR (101 MHz, CDCl₃): δ 179.2 (C), 154.3 (C), 135.7 (4C; CH), 133.1 (2C; C), 132.7 (C), 130.0 (2C; CH), 129.1 (2C; CH), 127.9 (4C; CH), 119.8 (2C; CH), 35.9 (CH₂), 29.9 (CH₂), 26.7 (3C; CH₃), 19.6 (C).

DMAP (8.2 mg, 0.0667 mmol), EDC.HCl (25.6 mg, 0.133 mmol) and 1,3-diglyceride Int-2 (41.7 mg, 0.0734 mmol) were added to a solution of acid Int-65 (27.0 mg, 0.0666 mmol) in CH₂Cl₂ (2 mL) and the mixture stirred at room temperature for 19 hours. The reaction was diluted with CH₂Cl₂ (3 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (5% to 7.5% ethyl acetate/hexanes) gave triglyceride Int-66 (54.4 mg, 85%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.74-7.66 (m, 4H), 7.45-7.33 (m, 6H), 6.94-6.87 (m, 2H), 6.71-6.64 (m, 2H), 5.24 (m, 1H), 4.25 (dd, J=11.9, 4.3 Hz, 2H), 4.11 (dd, J=11.9, 5.9 Hz, 2H), 2.81 (t, J=7.8 Hz, 2H), 2.60-2.51 (m, 2H), 2.28 (t, J=7.5 Hz, 4H), 1.64-1.56 (m, 4H), 1.35-1.20 (m, 48H), 1.09 (s, 9H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.2 (C), 154.2 (C), 135.7 (4C; CH), 133.1 (2C; C), 132.7 (C), 130.0 (2C; CH), 129.1 (2C; CH), 127.9 (4C; CH), 119.8 (2C; CH), 69.2 (CH), 62.1 (2C; CH₂), 36.0 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 30.1 (CH₂), 29.85 (2C; CH₂), 29.81 (2C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 26.7 (3C; CH₃), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.6 (C), 14.3 (2C; CH₃).

Acetic acid (6.5 μL, 0.114 mmol) and tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 114 μL, 0.114 mmol) were added to a solution of TBDPS ether Int-66 (54.5 mg, 0.0570 mmol) in THF (1.2 mL) at 0° C. and the mixture stirred at room temperature for 30 minutes. The reaction was diluted with water (10 mL) and the aqueous layer extracted with ethyl acetate (3×10 mL). The combined organic extracts were washed with sat. aq. NaHCO₃ (20 mL) and brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 15% ethyl acetate/hexanes) gave phenol Int-67 (37.0 mg, 90%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.09-7.03 (m, 2H), 6.78-6.72 (m, 2H), 5.25 (m, 1H), 4.62 (s, 1H), 4.25 (dd, J=11.9, 4.4 Hz, 2H), 4.11 (dd, J=11.9, 5.8 Hz, 2H), 2.88 (t, J=7.7 Hz, 2H), 2.61 (t, J=7.7 Hz, 2H), 2.29 (t, J=7.6 Hz, 4H), 1.64-1.56 (m, 4H), 1.34-1.18 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (2C; C), 172.3 (C), 154.4 (C), 132.3 (C), 129.5 (2C; CH), 115.5 (2C; CH), 69.2 (CH), 62.2 (2C; CH₂), 36.2 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 30.2 (CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃).

C6-ET-alcohol-2-TG (Int-73):

Int-69 is a known compound that may be prepared as described in, e.g., Sang-sup, J. et al. Tetrahedron: Asymmetry 1997, 8, 1187-1192).

Alcohol Int-68 (commercially available; 90.0 mg, 0.499 mmol) was added in a single portion to a suspension of t-BuOK (84.1 mg, 0.749 mmol) in THF (2 mL) and the mixture stirred at room temperature for one hour. A solution of bromide Int-69 (190 mg, 0.699 mmol) in THF (1 mL) and TBAI (36.9 mg, 0.100 mmol) were then added and the resulting mixture heated at reflux for 20 hours. The reaction was cooled to room temperature and diluted with ethyl acetate (10 mL), quenched with water (15 mL) and the aqueous phase extracted with ethyl acetate (3×20 mL). The combined organic extracts were washed with water and brine (50 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (5 to 15% to 25% ethyl acetate/hexanes) gave a sample of semi-pure product, which was re-subjected to column chromatography (5% to 12.5% ethyl acetate/toluene) to give ether-linked glycerol Int-70 (48.0 mg, 26%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 7.54-7.49 (m, 2H), 7.39-7.26 (m, 8H), 5.55 (s, 1H), 4.50 (s, 2H), 4.33 (dd, J=12.5, 1.4 Hz, 2H), 4.07-4.01 (m, 2H), 3.55 (t, J=6.7 Hz, 2H), 3.47 (t, J=6.6 Hz, 2H), 3.25 (m, 1H), 1.71-1.59 (m, 4H), 1.45-1.39 (m, 4H).

A mixture of benzylidene acetal Int-70 (46.0 mg, 0.124 mmol), conc. HCl (2 drops) and MeOH (1.5 mL) was heated at reflux for two hours and then cooled to room temperature. The reaction was diluted with ethyl acetate (30 mL) and water (10 mL), and the organic phase washed sat. aq. NaHCO₃, water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (40% to 80% ethyl acetate/hexanes) gave diol Int-71 (23.5 mg, 67%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 7.36-7.27 (m, 5H), 4.50 (s, 2H), 3.76 (dd, J=11.6, 4.4 Hz, 2H), 3.67 (dd, J=11.6, 5.1 Hz, 2H), 3.57 (t, J=6.6 Hz, 2H), 3.50-3.42 (m, 3H), 1.67-1.56 (m, 4H), 1.43-1.36 (m, 4H).

A solution of freshly-prepared palmitoyl chloride (91.6 mg, 0.333 mmol) in CH₂Cl₂ (1.5 mL) and pyridine (30.3 μL, 0.375 mmol) were added to the diol Int-71 (23.5 mg, 0.0833 mmol) and the reaction stirred at room temperature for 16 hours. The reaction mixture was diluted with CH₂Cl₂ (30 mL) and quenched with water (10 mL). The organic phase was washed with water, sat. aq. NaHCO₃ and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (5% to 10% ethyl acetate/hexanes) gave glyceride Int-72 (44.8 mg, 71%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 7.36-7.26 (m, 5H), 4.50 (s, 2H), 4.18 (dd, J=11.6, 4.9 Hz, 2H), 4.11 (dd, J=11.6, 5.5 Hz, 2H), 3.68 (dd, J=10.4, 5.3 Hz, 1H), 3.55 (t, J=6.6 Hz, 2H), 3.46 (t, J=6.6 Hz, 2H), 2.32 (t, J=7.6 Hz, 4H), 1.67-1.54 (m, 8H), 1.34-1.21 (m, 52H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (2C; C), 138.8 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 75.3 (CH), 73.0 (CH₂), 70.7 (CH₂), 70.5 (CH₂), 63.2 (2C; CH₂), 34.3 (2C; CH₂), 32.1 (2C; CH₂), 30.0 (CH₂), 29.87 (CH₂), 29.84 (2C; CH₂), 29.80 (2C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 26.2 (CH₂), 26.0 (CH₂), 25.1 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃).

A solution of benzyl ether Int-72 (43.5 mg, 57.3 μmol) in ethyl acetate/hexanes (10 mL each) was subjected to hydrogenolysis using an HCube hydrogenation apparatus under recycling conditions (10% Pd/C cartridge, full H2 mode at 6 bar, flow rate=1 mL/min), with the column temperature set at 25° C. for 1.5 hours then at 35° C. for a further hour. Concentration of the reaction mixture under reduced pressure gave alcohol Int-73 (38.2 mg, quant.) as a colorless solid that was used without purification. ¹H NMR (400 MHz, CDCl₃): δ 4.19 (dd, J=11.6, 4.9 Hz, 2H), 4.11 (dd, J=11.6, 5.5 Hz, 2H), 3.67 (m, 1H), 3.64 (t, J=6.5 Hz, 2H), 3.55 (t, J=6.5 Hz, 2H), 2.32 (t, J=7.6 Hz, 4H), 1.66-1.56 (m, 8H), 1.41-1.34 (m, 4H), 1.33-1.18 (m, 48H), 0.88 (t, J=6.8 Hz, 6H).

C4-ET-alcohol-2-TG (Int-78):

Int-74 is a known compound that may be prepared as described in Charette, A. B. et al. J Am. Chem. Soc. 2001, 123, 11829-11830.

Alcohol Int-68 (commercially available; 135 mg, 0.749 mmol) was added in a single portion to a suspension of t-BuOK (118 mg, 1.05 mmol) in THF (2.5 mL) and the mixture stirred at RT for one hour. A solution of bromide Int-74 (273 mg, 1.12 mmol) in THF (2 mL) was then added and the resulting mixture heated at reflux for 26 hours. The reaction was cooled to room temperature and diluted with ethyl acetate (10 mL), quenched with water (20 mL) and the aqueous phase extracted with ethyl acetate (3×25 mL). The combined organic extracts were washed with water and brine (60 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave ether-linked glycerol Int-75 (103 mg, 40%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 7.53-7.48 (m, 2H), 7.38-7.27 (m, 8H), 5.55 (s, 1H), 4.50 (s, 2H), 4.37-4.27 (m, 2H), 4.08-3.98 (m, 2H), 3.61-3.55 (m, 2H), 3.54-3.50 (m, 2H), 3.25 (m, 1H), 1.82-1.65 (m, 4H); ¹³C NMR (100 MHz, CDCl₃): δ 138.8 (C), 138.3 (C), 128.9 (CH), 128.4 (2C; CH), 128.3 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 126.3 (2C; CH), 101.4 (C), 73.0 (CH₂), 70.7 (CH), 70.3 (CH₂), 69.1 (2C; CH₂), 68.7 (CH₂), 26.7 (CH₂), 26.6 (CH₂).

A mixture of benzylidene acetal Int-75 (102 mg, 0.298 mmol), conc. HCl (2 drops) and MeOH (4 mL) was heated at reflux for two hours and then cooled to RT. The reaction was diluted with ethyl acetate (40 mL) and water (15 mL), and the organic phase washed sat. aq. NaHCO₃, water and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (25% to 65% to 90% ethyl acetate/hexanes) gave diol Int-76 (58.8 mg, 78%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 7.38-7.24 (m, 5H), 4.50 (s, 2H), 3.71 (dd, J=11.6, 4.6 Hz, 2H), 3.64 (dd, J=11.6, 4.9 Hz, 2H), 3.60-3.55 (m, 2H), 3.52-3.46 (m, 2H), 3.41 (m, 1H), 2.59 (br s, 2H), 1.75-1.61 (m, 4H); ¹³C NMR (100 MHz, CDCl₃): δ 138.5 (C), 128.5 (2C; CH), 127.8 (2C; CH), 127.7 (CH), 78.8 (CH), 73.0 (CH₂), 70.2 (CH₂), 69.8 (CH₂), 62.2 (2C; CH₂), 27.1 (CH₂), 26.4 (CH₂).

A solution of palmitoyl chloride (131 mg, 0.475 mmol) in CH₂Cl₂ (2 mL) and pyridine (48.0 μL, 0.594 mmol) were added to the diol Int-76 (30.2 mg, 0.119 mmol) and the reaction stirred at room temperature for 19 hours. The reaction mixture was diluted with CH₂Cl₂ (40 mL) and quenched with water (20 mL). The organic phase was washed with water, sat. aq. NaHCO₃ and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (6% ethyl acetate/hexanes) gave triglyceride Int-77 (72.4 mg, 83%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 7.38-7.26 (m, 5H), 4.50 (s, 2H), 4.18 (dd, J=11.6, 4.9 Hz, 2H), 4.11 (dd, J=11.6, 5.5 Hz, 2H), 3.67 (m, 1H), 3.58 (t, J=6.1 Hz, 2H), 3.48 (t, J=6.1 Hz, 2H), 2.31 (t, J=7.6 Hz, 4H), 1.73-1.55 (m, 8H), 1.37-1.19 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (2C; C), 138.7 (C), 128.5 (2C; CH), 127.7 (2C; CH), 127.6 (CH), 75.4 (CH), 73.0 (CH₂), 70.4 (CH₂), 70.2 (CH₂), 63.1 (2C; CH₂), 34.3 (2C; CH₂), 32.1 (2C; CH₂), 29.82 (6C; CH₂), 29.79 (4C; CH₂), 29.74 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; H2), 29.3 (2C; CH₂), 26.8 (CH₂), 26.5 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.2 (2C; CH₃).

A solution of benzyl ether Int-77 (70.0 mg, 95.8 μmol) in ethyl acetate/hexanes (25 mL each) was subjected to hydrogenolysis using an HCube hydrogenation apparatus under recycling conditions (10% Pd/C cartridge, full H2 mode at 6 bar, flow rate=1 mL/min), with the column temperature set at 50° C. for 2.5 hours. Concentration of the reaction mixture under reduced pressure gave the crude product, which was purified by silica gel chromatography (10% to 30% ethyl acetate/hexanes) to give alcohol Int-78 (55.0 mg, 90%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 4.20 (dd, J=11.7, 4.8 Hz, 2H), 4.11 (dd, J=11.7, 5.5 Hz, 2H), 3.69 (m, 1H), 3.64 (t, J=5.9 Hz, 2H), 3.60 (t, J=5.8 Hz, 2H), 2.32 (t, J=7.5 Hz, 4H), 1.70-1.55 (m, 8H), 1.33-1.19 (m, 48H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (2C; C), 75.5 (CH), 70.5 (CH₂), 63.0 (2C; CH₂), 62.6 (CH₂), 34.3 (2C; CH₂), 32.0 (2C; CH₂), 29.9 (CH₂), 29.82 (2C; CH₂), 29.78 (2C; CH₂), 29.7 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 26.7 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.2 (2C; CH₃).

C5ββDiMe-acid-2-TG (Int-79):

To a solution of compound Int-2 (5.0 g, 8.78 mmol) in chloroform (150 ml) was added DCC (3.62 g, 17.57 mmol) and DMAP (0.53 g, 4.39 mmol), followed by addition of 3,3-dimethylglutaric acid (2.81 g, 17.57 mmol) at room temperature and then stirring for 48 h. The reaction was monitored by TLC. After completion of the reaction, the reaction mixture was filtered through a celite bed and washed with dichloromethane (100 ml) and the filtrate was evaporated to give the crude desired compound, which was purified by combi-flash purification. The compound was eluted using 6% ethyl acetate in hexane and concentrated to give Int-79 (C5ββDiMe-acid-2-TG) (2.0 g, 32%) as off-white solid. ¹H NMR (400 MHz, CDCl₃) δ 5.33 (m, 1H), 4.33 (m, 2H), 4.18 (m, 2H), 2.51 (s, 4H), 2.35 (t, 4H), 1.64 (t, 4H), 1.29 (m, 49H), 1.19 (s, 6H), 0.92 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 176.4 (1C), 173.3 (2C), 171.0 (1C), 69.1 (1C), 62.1 (2C), 45.0 (1C) 44.7 (1C), 34.0 (3C), 32.6 (1C), 31.9 (3H), 29.7-29.1 (14C), 27.7 (3C), 24.8 (3C), 22.7 (3C), 14.1 (3C); HPLC (ELSD): 10.07 min, 97.74% purity; MASS (ESI, −ve) m/z: 710 (M−1).

C12a′aMe-acid-2-TG (Int-81):

To a solution of diisopropylamine (DIPA) (3.18 g, 81.08 mmol) in dry THF (45 mL) was added n-BuLi (2.5 M in hexane) (32 mL, 81.08 mmol) at −78° C. The reaction mixture was stirred at −78° C. for 30 min, then then propionic acid (1.5 g, 20.27 mmol) was added and the reaction mixture was stirred at −78° C. for further 30 min. 1,8-dibromooctane (2.75 g, 10.13 mmol) was added and the reaction mixture was stirred and allowed to warm from −78° C. to room temperature over 3 h. The reaction was monitored by TLC for completeness. An additional identical batch starting with 1.5 g propionic acid was prepared and the two batches combined before workup. The combined reaction mixture was diluted with water (100 mL) and acidified with 1N HCl (25 ml) and extracted with ethyl acetate (3×100 ml), and the combined organic layer was dried over Na₂SO₄ and evaporated to give crude compound. The title compound was purified by combi flash purification, eluting with 10% ethyl acetate/hexane as the mobile phase. After evaporation, Int-80 (0.99 g, 9.5%) was obtained as an off-white solid. ¹H NMR (400 MHz, CDCl₃) δ 2.57-2.39 (m, 2H), 1.71 (m, 2H), 1.50-1.43 (m, 2H), 1.40-1.25 (m, 14H), 1.22 (d, J=7.2 Hz 6H).

To a solution of compound Int-2 (2.7 g, 4.74 mmol) in chloroform (50 ml) was added DCC (1.95 g, 9.49 mmol) and DMAP (0.28 g, 2.30 mmol), then the reaction was stirred at room temperature for 30 min. Int-80 (2.44 g, 9.49 mmol) was added at room temperature and stirred for 2 h. The reaction was monitored by TLC until completion, after which the reaction mixture was filtered through celite and washed with DCM (45 ml), then evaporated to give the crude product, which was purified by combi flash purification, eluting with 7% ethyl acetate/hexane. After evaporation, Int-81 (C12a′aMe-acid-2-TG) (1.7 g, 44.3%) was obtained as an off-white solid. ¹H NMR (400 MHz, CDCl₃) δ 5.32 (m, 1H), 4.33 (m, 2H), 4.19 (m, 2H), 2.49 (m, 2H), 2.34 (m, 4H), 1.72-1.62 (m, 4H), 1.49-1.40 (m, 4H). 1.38-1.29 (m, 59H), 1.24-1.17 (m, 8H), 0.92 (m, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 181.7 (1C), 176.0 (1C), 173.4 (2C), 68.7 (2C), 62.2 (3C), 39.6 (2C), 39.2 (1C), 34.1 (3C), 33.7 (1C), 32.0 (3C), 29.7-29.2 (17C), 27.2 (1C), 24.9 (3C), 22.7 (3C), 17.1 (2C), 16.9 (1C), 14.2 (3C).

Bromotriglyceride Int-91:

DMAP (10.7 mg, 0.0979 mmol) and EDC.HCl (41.8 mg, 0.220 mmol) were added to a solution of bromoacetic acid (24.4 mg, 0.176 mmol) and Int-2 (50.0 mg, 0.0879 mmol) in CH₂Cl₂ (2 mL) and the mixture stirred at RT for 22 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the solvent removed under reduced pressure. Silica gel chromatography (4% ethyl acetate/hexanes) gave bromotriglyceride Int-91 (50.3 mg, 83%) as a colorless solid. 1H NMR (400 MHz, CDCl₃) δ 5.31 (m, 1H), 4.34 (dd, J=12.1, 4.0 Hz, 2H), 4.17 (dd, J=12.1, 6.1 Hz, 2H), 3.84 (s, 2H), 2.32 (t, J=7.6 Hz, 4H), 1.66-1.56 (m, 4H), 1.35-1.20 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 166.7 (C), 71.3 (CH), 61.9 (2C; CH₂), 34.1 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (2C; CH₂), 29.80 (2C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.5 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₂).

Iodotriglyceride Int-95:

Int-93 is a known compound prepared from cycloheptanone as shown above (see Kai, K. et al. Tetrahedron 2008, 64, 6760-6769). To prepare Int-94, chlorotrimethylsilane (TMSCl, 208 μL, 1.64 mmol) was added to a suspension of lactone Int-93 (70.0 mg, 0.546 mmol) and sodium iodide (246 mg, 1.64 mmol) in acetonitrile (1.5 mL) and the mixture heated at reflux for 16 hours. The reaction was cooled to RT, diluted with ethyl acetate and water (10 mL each), and extracted with ethyl acetate (3×15 ml). The combined organic extracts were washed with 1 M Na₂S₂O₃ and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (100% CH₂Cl₂ to 50% ethyl acetate/hexanes) gave semi-pure acid Int-94 (59.8 mg, 43%) as a yellow oil. However, an accurate yield and clean NMR spectra could not be obtained due to the presence of the m-CPBA impurities, which were carried forward to the next step. ¹H NMR (400 MHz, CDCl₃) δ 3.19 (t, J=7.0 Hz, 2H), 2.37 (t, J=7.4 Hz, 2H), 1.88-1.80 (m, 2H), 1.71-1.61 (m, 2H), 1.46-1.33 (m, 4H).

DMAP (15.2 mg, 0.124 mmol) and DCC (51.3 mg, 0.248 mmol) were added sequentially to a solution of acid Int-94 (35.0 mg, 0.137 mmol) and 1,3-diglyceride Int-2 (70.7 mg, 0.124 mmol) in CH₂Cl₂ (4 mL) and the mixture stirred at RT for 17 hours. The resulting suspension was diluted with CH₂Cl₂, cooled to 0° C. and filtered through Celite, washing with further CH₂Cl₂. The organic phase was washed with 1 M HCl, sat. aq. NaHCO₃ and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (3.5% to 4.5% ethyl acetate/hexanes) gave semi-pure iodotriglyceride Int-95 (83.6 mg, 84%) as a colorless solid. However, an accurate yield and clean NMR spectra could not be obtained due to the presence of the m-CPBA impurities, which were carried forward to the next step. ¹H NMR (400 MHz, CDCl₃) δ 5.26 (m, 1H), 4.30 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.18 (t, J=7.0 Hz, 2H), 2.36-2.27 (m, 6H), 1.86-1.77 (m, 2H), 1.68-1.52 (m, 6H), 1.45-1.18 (m, 52H), 0.88 (t, J=6.9 Hz, 6H).

DMAP (17.2 mg, 0.141 mmol) and EDC.HCl (67.4 mg, 0.352 mmol) were added to a solution of 1,3-diglyceride Int-2 (80.0 mg, 0.141 mmol) and 12-bromododecanoic acid (51.0 mg, 0.183 mmol) in CH₂Cl₂ (2.5 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (10 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (5% to 10% ethyl acetate/hexanes) gave bromotriglyceride Int-97 (105 mg, 90%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 5.25 (m, 1H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.13 (dd, J=11.9, 5.9 Hz, 2H), 3.38 (t, J=6.9 Hz, 2H), 2.30 (t, J=7.5 Hz, 2H), 2.29 (t, J=7.5 Hz, 4H), 1.88-1.79 (m, 2H), 1.65-1.55 (m, 6H), 1.45-1.36 (m, 2H), 1.34-1.18 (m, 60H), 0.86 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.9 (C), 69.0 (CH), 62.2 (2C; CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 33.0 (CH₂), 32.1 (2C; CH₂), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.74 (2C; CH₂), 29.60 (3C; CH₂), 29.54 (2C; CH₂), 29.48 (2C; CH₂), 29.39 (2C; CH₂), 29.38 (CH₂), 29.23 (2C; CH₂), 29.17 (CH₂), 28.9 (CH₂), 28.3 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.2 (2C; CH₃).

Int-105:

Int-99:

A suspension of 1,16-hexanediol (200 mg, 0.774 mmol) in DMF (2 mL) was added a suspensiom of NaH (34.1 mg, 60% w/w dispersion in mineral oil, washed twice with dry petrol, 8.51 mmol) in DMF (1 mL) at 0° C. and the mixture stirred at 0° C. for 10 minutes and then at rt for 30 minutes. TBDPSCl (221 μL, 0.851 mmol) was added and the mixture stirred at rt for 17 hours. The reaction was diluted with ethyl acetate (50 mL), washed with water and brine (2×40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% ethyl acetate/hexanes) gave TBDPS ether Int-99 (124 mg, 32%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.70-7.63 (m, 4H), 7.45-7.34 (m, 6H), 3.64 (td, J=6.5, 3.6 Hz, 4H), 1.61-1.46 (m, 4H), 1.39-1.19 (m, 24H), 1.04 (s, 9H).

Int-100:

Pyridinium chlorochromate (PCC, 106 mg, 0.491 mmol) and Celite (100 mg) were added to alcohol Int-99 (122 mg, 0.246 mmol) in CH₂Cl₂ (6 mL) at 0° C. and the mixture stirred at 0° C. for 10 minutes and then at rt for 1. 5 hours. The reaction was filtered through a short pad of silica gel, eluting with 50% ethyl acetate/hexanes (80 mL), and the filtrate concentrated under reduced pressure to give crude aldehyde Int-100 (121 mg, quant.) as a yellow oil that was immediately used without purification.

Int-101:

Ylide methyl 2-(triphenyl-λ⁵-phosphaneylidene)acetate (205 mg, 0.614 mmol) was added to crude aldehyde Int-100 (121 mg, 0.246 mmol) in toluene (6 mL) and the mixture heated at reflux for one hour. The reaction was cooled to rt and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (4% ethyl acetate/hexanes) gave alpha,beta-unsaturated methyl ester Int-101 (100 mg, 74%, 6:1 mixture of E/Z isomers) as a yellow oil. NMR data is provided for the major isomer. ¹H NMR (401 MHz, CDCl₃) δ 7.74-7.66 (m, 4H), 7.48-7.36 (m, 6H), 7.01 (dt, J=15.6, 7.0 Hz, 1H), 5.85 (dt, J=15.6, 1.5 Hz, 1H), 3.74 (s, 3H), 3.69 (t, J=6.5 Hz, 2H), 2.22 (qd, J=7.3, 1.5 Hz, 2H), 1.64-1.55 (m, 2H), 1.47 (dd, J=13.9, 6.9 Hz, 2H), 1.42-1.25 (m, 22H), 1.09 (s, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 167.3 (C), 149.9 (CH), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 120.9 (CH), 64.1 (CH₂), 51.4 (CH₃), 32.7 (CH₂), 32.3 (CH₂), 29.79 (2C; CH₂), 29.75 (2C; CH₂), 29.74 (CH₂), 29.66 (CH₂), 29.52 (CH₂), 29.50 (CH₂), 29.3 (CH₂), 28.1 (CH₂), 27.0 (3C; CH₂), 25.9 (CH₂), 19.3 (C).

Int-102:

A solution of alkene Int-101 (99.0 mg, 0.180 mmol) in ethyl acetate (5 mL) in a two-neck flask was evacuated and flushed with N2 gas three times each, then palladium on carbon (10% w/w, 28.7 mg, 0.0270 mmol) was added and the resulting suspension re-evacuated and flushed with N2 three times. The flask was fitted with a H2 balloon, evacuated and flushed with H2 three times and the reaction mixture stirred at rt under 1 atm of H2 for one hour. The reaction was filtered through a pad of Celite, washing with ethyl acetate (80 mL), and concentrated under reduced pressure to give saturated methyl ester Int-102 (99.4 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (401 MHz, CDCl₃) δ 7.75-7.67 (m, 4H), 7.47-7.36 (m, 6H), 3.69 (t, J=6.5 Hz, 2H), 3.68 (s, 3H), 2.33 (t, J=7.5 Hz, 2H), 1.70-1.54 (m, 4H), 1.43-1.23 (m, 26H), 1.09 (s, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 174.4 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.1 (CH₂), 51.5 (CH₃), 34.2 (CH₂), 32.7 (CH₂), 29.82 (2C; CH₂), 29.81 (2C; CH₂), 29.78 (CH₂), 29.76 (CH₂), 29.75 (CH₂), 29.73 (CH₂), 29.6 (CH₂), 29.5 (CH₂), 29.4 (CH₂), 29.3 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 25.1 (CH₂), 19.3 (C).

Int-103:

A solution of potassium hydroxide (2.0 M, 530 μL, 1.06 mmol) was added to ester Int-102 (26.0 mg. 0.0854 mmol) in ethanol (3 mL) and the mixture heated at 70° C. for 50 minutes. The reaction was acidified to pH 3 by addition of 1 M HCl and diluted with ethyl acetate (40 mL). The organic phase was washed with water (2×30 mL) and brine (30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (15% ethyl acetate/hexanes) gave acid Int-103 (76.8 mg, 80%) as a colorless oil.

¹H NMR (401 MHz, CDCl₃) δ 7.73-7.67 (m, 4H), 7.44-7.37 (m, 6H), 3.68 (t, J=6.5 Hz, 2H), 2.37 (t, J=7.5 Hz, 2H), 1.70-1.53 (m, 4H), 1.41-1.23 (m, 26H), 1.07 (s, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 180.4 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 64.2 (CH₂), 34.2 (CH₂), 32.7 (CH₂), 29.83 (4C; CH₂), 29.81 (CH₂), 29.78 (2C; CH₂), 29.76 (CH₂), 29.6 (CH₂), 29.5 (CH₂), 29.4 (CH₂), 29.2 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 24.8 (CH₂), 19.4 (C).

Int-104:

DMAP (10.2 mg, 0.0839 mmol), EDC.HCl (40.2 mg, 0.210 mmol) and 1,3-diglyceride Int-2 (52.5 mg, 0.0923 mmol) were added to a solution of acid Int-103 (45.2 mg, 0.0839 mmol) in CH₂Cl₂ (4 mL) and the mixture stirred at RT for 22 hours. The reaction was diluted with CH₂Cl₂ (10 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (4% to 6% ethyl acetate/hexanes) gave triglyceride Int-104 (84.9 mg, 93%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.71-7.65 (m, 4H), 7.45-7.34 (m, 6H), 5.28 (m, 1H), 4.31 (dd, J=11.9, 4.3 Hz, 2H), 4.16 (dd, J=11.9, 6.0 Hz, 2H), 3.66 (t, J=6.5 Hz, 2H), 2.325 (t, J=7.5 Hz, 2H), 2.319 (t, J=7.5 Hz, 4H), 1.69-1.52 (m, 8H), 1.42-1.20 (m, 74H), 1.06 (s, 9H), 0.89 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 173.0 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 69.0 (CH), 64.1 (CH₂), 62.2 (2C; CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 32.7 (CH₂), 32.1 (2C; CH₂), 29.86 (2C; CH₂), 29.84 (9C; CH₂), 29.80 (5C; CH₂), 29.77 (2C; CH₂), 29.76 (2C; CH₂), 29.65 (CH₂), 29.61 (2C; CH₂), 29.53 (CH₂), 29.50 (2C; CH₂), 29.44 (CH₂), 29.41 (2C; CH₂), 29.25 (2C; CH₂), 29.22 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 25.04 (CH₂), 24.99 (2C; CH₂), 22.8 (2C; CH₂), 19.3 (C), 14.2 (2C; CH₃).

Int-105:

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 154 μL, 0.154 mmol) and acetic acid (8.8 μL, 0.154 mmol) were added to a solution of TBDPS ether Int-104 (84.0 mg, 0.0771 mmol) in THF (3 mL) at 0° C. and the mixture stirred at 0° C. for 15 minutes and then at rt for seven hours. The reaction was diluted with ethyl acetate (40 mL), washed with water (30 mL) and brine (2×30 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (7.5% to 20% ethyl acetate/hexanes) gave alcohol Int-105 (40.5 mg, 62%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 5.26 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.0 Hz, 2H), 3.64 (t, J=6.6 Hz, 2H), 2.31 (t, J=7.5 Hz, 2H), 2.30 (t, J=7.5 Hz, 4H), 1.67-1.51 (m, 8H), 1.44-1.17 (m, 74H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 173.1 (C), 69.0 (CH), 63.3 (CH₂), 62.3 (2C; CH₂), 34.4 (CH₂), 34.2 (2C; CH₂), 33.0 (CH₂), 32.1 (2C; CH₂), 29.82 (10C; CH₂), 29.80 (6C; CH₂), 29.76 (3C; CH₂), 29.75 (CH₂), 29.65 (CH₂), 29.63 (2C; CH₂), 29.59 (CH₂), 29.51 (2C; CH₂), 29.45 (CH₂), 29.42 (2C; CH₂), 29.27 (2C; CH₂), 29.23 (CH₂), 25.9 (CH₂), 25.1 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃).

Int-110 (TML(CO₂H)-C4-2-TG):

Int-106: prepared according to: Amsberry, K. L. et al. Pharm Res. 1991, 8, 455-461.

DMAP (18.3 mg, 0.149 mmol) and EDC.HCl (71.6 mg, 0.374 mmol) were added to a solution of Int-28 (100 mg, 0.149 mmol) and phenol Int-106 (53.0 mg, 0.164 mmol) in CH₂Cl₂ (4 mL) and the mixture stirred at room temperature for 19 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (3% to 7.5% ethyl acetate/hexanes) gave TML-TG Int-107 (84.6 mg, 58%) as a colourless oil. ¹H NMR (400 MHz, CDCl₃) δ 6.80 (d, J=2.0 Hz, 1H), 6.55 (d, J=1.9 Hz, 1H), 5.29 (m, 1H), 4.31 (dd, J=11.9, 4.4 Hz, 2H), 4.16 (dd, J=12.0, 5.8 Hz, 2H), 3.51-3.44 (m, 2H), 2.85 (t, J=6.9 Hz, 2H), 2.75 (t, J=6.9 Hz, 2H), 2.51 (s, 3H), 2.30 (t, J=7.6 Hz, 4H), 2.22 (s, 3H), 2.06-1.99 (m, 2H), 1.65-1.56 (m, 4H), 1.46 (s, 6H), 1.37-1.20 (m, 48H), 0.88 (t, J=6.9 Hz, 6H), 0.84 (s, 9H), −0.03 (s, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 171.5 (C), 171.3 (C), 149.7 (C), 138.5 (C), 136.1 (C), 134.1 (C), 132.5 (CH), 123.1 (CH), 69.8 (CH), 62.0 (2C; CH₂), 60.9 (CH₂), 46.1 (CH₂), 39.2 (C), 34.1 (2C; CH₂), 32.1 (2C; CH₂), 31.9 (2C; CH₃), 29.9 (CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 29.0 (CH₂), 26.1 (3C; CH₃), 25.4 (CH₃), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 20.3 (CH₃), 18.3 (C), 14.3 (2C; CH₃), −5.21 (2C; CH₃). ESI-HRMS: calcd. for C₅₈H₁₁₀O₉Si [M+H⁺] 973.7522; found 973.7515.

10-Camphorsulfonic acid (3.0 mg, 12.9 μmol) was added to TBS ether Int-107 (83.7 mg, 86.0 μmol) in CH₂Cl₂ (1 mL) and MeOH (1 mL) and the mixture stirred at room temperature for one hour. The reaction was diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ and brine (20 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (15% to 25% ethyl acetate/hexanes) gave alcohol Int-108 (59.9 mg, 81%) as a colourless oil. ¹H NMR (400 MHz, CDCl₃) δ 6.81 (d, J=2.0 Hz, 1H), 6.56 (d, J=1.4 Hz, 1H), 5.28 (m, 1H), 4.30 (dd, J=12.0, 4.4 Hz, 2H), 4.17 (dd, J=12.0, 5.8 Hz, 2H), 3.51 (t, J=6.8 Hz, 2H), 2.88 (t, J=6.6 Hz, 2H), 2.75 (t, J=6.6 Hz, 2H), 2.52 (s, 3H), 2.29 (t, J=7.6 Hz, 4H), 2.22 (s, 3H), 2.05 (t, J=7.4 Hz, 2H), 1.65

-   -   1.57 (m, 4H), 1.50 (s, 6H), 1.37-1.20 (m, 48H), 0.88 (t, J=6.9         Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 171.71 (C),         171.70 (C), 149.8 (C), 138.5 (C), 136.3 (C), 133.9 (C), 132.6         (CH), 123.2 (CH), 69.8 (CH), 62.0 (2C; CH₂), 60.5 (CH₂), 45.9         (CH₂), 39.2 (C), 34.1 (2C; CH₂), 32.1 (2C; CH₃), 32.0 (2C; CH₂),         29.84 (CH₂), 29.80 (6C; CH₂), 29.77 (4C; CH₂), 29.72 (2C; CH₂),         29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂),         28.9 (CH₂), 25.5 (CH₃), 24.9 (2C; CH₂), 22.8 (2C; CH₂), 20.3         (CH₃), 14.2 (2C; CH₃). ESI-HRMS: calcd. for C₅₂H₉₀NaO₉ [M+Na⁺]         881.6477; found 881.6489.

Pyridinium chlorochromate (PCC, 30.1 mg, 0.139 mmol) was added to a suspension of alcohol Int-108 (59.9 mg, 0.0697 mmol) and Celite (30 mg) in CH₂Cl₂ (3 mL) at 0° C. and the mixture stirred at room temperature for two hours. The reaction was filtered through a short pad of silica gel, eluting with 50% ethyl acetate/hexanes (50 mL), and the filtrate concentrated under reduced pressure to give crude aldehyde Int-109 (59.8 mg, quant.) as a yellow oil that was used without purification. ¹H NMR (400 MHz, CDCl₃) δ 9.54 (t, J=2.6 Hz, 1H), 6.84 (d, J=2.0 Hz, 1H), 6.60 (d, J=1.4 Hz, 1H), 5.28 (m, 1H), 4.30 (dd, J=12.0, 4.3 Hz, 2H), 4.16 (dd, J=12.0, 5.8 Hz, 2H), 2.86 (t, J=6.7 Hz, 2H), 2.83 (d, J=2.6 Hz, 2H), 2.75 (t, J=6.3 Hz, 2H), 2.53 (s, 3H), 2.30 (t, J=7.6 Hz, 4H), 2.23 (s, 3H), 1.64-1.58 (m, 4H), 1.56 (s, 3H), 1.55 (s, 3H), 1.32-1.22 (m, 48H), 0.88 (t, J=6.9 Hz, 6H).

Potassium permanganate (12.2 mg, 76.7 mol) in 1:1 acetone/water (1.6 mL total) was added to aldehyde Int-109 (59.8 mg, 69.7 μmol) in acetone (1.6 mL) and the mixture stirred at room temperature for 17 hours. The reaction was diluted with water (10 mL), acidified to pH 2 using 1 M HCl, and the aqueous layer extracted with CH₂Cl₂ (3×15 mL). The combined organic extracts were washed with brine (40 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 25% ethyl acetate/hexanes) gave acid Int-110 (30.4 mg, 50%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 6.81 (d, J=1.6 Hz, 1H), 6.58 (d, J=1.4 Hz, 1H), 5.28 (m, 1H), 4.30 (dd, J=11.9, 4.4 Hz, 2H), 4.16 (dd, J=12.0, 5.8 Hz, 2H), 2.88 (t, J=6.6 Hz, 2H), 2.84 (s, 2H), 2.75 (t, J=6.6 Hz, 2H), 2.53 (s, 3H), 2.29 (t, J=7.6 Hz, 4H), 2.22 (s, 3H), 1.64-1.58 (m, J=9.3 Hz, 4H), 1.57 (s, 6H), 1.34-1.20 (m, 48H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 176.1 (C), 173.6 (2C; C), 171.6 (C), 171.4 (C), 149.5 (C), 138.2 (C), 136.5 (C), 133.4 (C), 132.7 (CH), 123.0 (CH), 69.8 (CH), 62.0 (2C; CH₂), 47.6 (CH₂), 38.8 (C), 34.1 (2C; CH₂), 32.1 (2C; CH₂), 31.5 (2C; CH₃), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 29.0 (CH₂), 25.4 (CH₃), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 14.3 (2C; CH₃). ESI-HRMS: calcd. for C₅₂H₈₈NaO₁₀ [M+Na⁺] 895.6270; found 895.6266.

Using similar methods, Int-119 was prepared by EDC coupling with Int-37 in 84% yield:

¹H NMR (401 MHz, CDCl₃) δ 6.80 (d, J=1.9 Hz, 1H), 6.55 (d, J=1.7 Hz, 1H), 5.26 (m, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 2.83 (s, 2H), 2.55 (t, J=7.5 Hz, 2H), 2.53 (s, 3H), 2.32 (t, J=7.5 Hz, 2H), 2.31 (t, J=7.5 Hz, 4H), 2.22 (s, 3H), 1.78-1.69 (m, 2H), 1.67-1.54 (m, 6H), 1.57 (s, 6H), 1.45-1.20 (m, 60H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 176.3 (C), 173.5 (2C; C), 173.1 (C), 173.0 (C), 149.7 (C), 138.2 (C), 136.4 (C), 133.5 (C), 132.5 (CH), 123.2 (CH), 69.0 (CH), 62.2 (2C; CH₂), 47.4 (CH₂), 38.9 (C), 35.2 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 31.4 (2C; CH₃), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.62 (2C; CH₂), 29.53 (2C; CH₂), 29.50 (2C; CH₂), 29.41 (2C; CH₂), 29.38 (2C; CH₂), 29.30 (CH₂), 29.26 (2C; CH₂), 29.19 (CH₂), 25.4 (CH₃), 25.0 (3C; CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 14.3 (2C; CH₃).

Int-122 was also prepared using similar methods:

¹H NMR (401 MHz, CDCl₃) δ 6.79 (d, J=1.9 Hz, 1H), 6.51 (d, J=1.8 Hz, 1H), 5.26 (m, 1H), 4.292/4.284 (each dd, J=11.8, 4.2 Hz, 2H), 4.14 (dd, J=11.9, 6.1 Hz, 2H), 2.84 (s, 2H), 2.67 (m, 1H), 2.53 (s, 3H), 2.44 (m, 1H), 2.30 (t, J=7.6 Hz, 4H), 2.22 (s, 3H), 1.84 (m, 1H), 1.69-1.45 (m, 7H), 1.573 (s, 3H), 1.567 (s, 3H), 1.45-1.19 (m, 63H), 1.14 (d, J=7.0 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 176.1 (2C; C), 175.9 (C), 173.5 (2C; C), 150.1 (C), 138.2 (C), 136.4 (C), 133.6 (C), 132.5 (CH), 123.0 (CH), 68.9 (CH), 62.30/62.27 (2C; CH₂), 47.3 (CH₂), 40.2 (CH), 39.7 (CH), 39.0 (C), 34.2 (2C; CH₂), 33.8 (CH₂), 33.6 (CH₂), 32.1 (2C; CH₂), 31.5 (CH₃), 29.84 (2C; CH₂), 29.80 (2C; CH₂), 29.76 (2C; CH₂), 29.65 (2C; CH₂), 29.61 (2C; CH₂), 29.59 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.28/29.27 (2C; CH₂), 27.34 (CH₂), 27.28 (CH₂), 25.5 (CH₃), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 17.2 (CH₃), 16.9 (CH₃), 14.3 (2C; CH₃).

Int-112 1,3-di-oleoyl glycerol (1,3-DG-oleate):

To a solution of 2,5-bis(hydroxymethyl)-1,4-dioxane-2,5-diol (5 g, 27.7 mol) in chloroform (20 vol) was added pyridine (5.5 mL, 69.4 mol) followed by oleoyl chloride (11 mL, 54.9 mol) and the mixture was stirred at room temperature for 1 h. The solvent was evaporated and the reaction mixture dissolved in ethyl acetate (30 vol) and washed with 1N HCl (10 vol). The organic layer was dried and solvent evaporated under vaccum. The crude material was recrystallized with cold methanol (20 vol). The solid obtained was further washed with cold methanol, and dried to give ketone Int-111 (11 g, 62%) as a white solid. ¹H NMR (400 MHz, CDCl₃) δ 5.36 (t, J=11.6 Hz, 4H), 4.78 (s, 4H), 2.47 (m, 4H), 2.38 (m, 8H), 1.71 (m, 2H), 1.34-1.30 (m, 42H), 0.93 (m, 6H).

Sodium borohydride (NaBH₄, 307 mg, 8.09 mmol), was added to a solution of Int-111 (5 g, 8.09 mmol) in THF (20 vol) at 0° C. and then the reaction mixture was stirred at room temperature for 15 mins. The reaction was monitored by TLC and after completion, the reaction mixture was filtered through a celite bed to remove excess of sodium borohydride and the celite bed was washed with ethyl acetate (30 vol), the organic layer was washed with 1N solution of acetic acid (10 vol). The solvent was dried over Na₂SO₄ and solvent removed under vacuum. The crude material was column purified. The product was eluted at 5%-10% ethyl acetate/hexane to afford 1,3-DG-oleate (Int-112) (2 g, 39%) as viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 5.39 (m, 4H), 4.20 (m, 5H), 2.44 (d, 1H), 2.36 (m, 4H), 2.01 (m, 8H), 2.47-2.25 (m, 12H), 2.17 (m, 1H), 2.02 (ddd, J=13.4, 4.9, 3.3 Hz, 1H), 1.85 (m, 1H), 1.77 (m, 1H), 1.64 (m, 2H), 1.57-1.26 (m, 42H), 0.9 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.9 (2C, C═O), 130.1 (2C), 129.7 (2C), 68.4 (C, CH), 65.1 (2C), 34.1 (2C), 31.9 (2C), 29.8-29.1 (18C), 27.3 (2C), 24.9 (2C), 22.7 (2C), 14.1 (2C). HPLC (ELSD): 9.62 min, 99.27% purity. MS (ESI, +ve) m/z: 639.2 (MH⁺+H₂O).

Int-113 (C10-acid-TG-oleate):

Pyridine (0.19 mL, 2.41 mmol) was added to a suspension of DG-oleate Int-112 (150 mg, 0.241 mmol) in DCM (20 Vol). After 5 min, sebacoyl chloride (289 mg, 1.2 mmol) was added dropwise with stirring at room temperature. Reaction mixture allowed to stir at 40° C. for 2 h. The reaction was monitored by TLC and after completion, diluted with DCM (20 vol), washed with water (20 vol), aqueous sodium bicarbonate (10 vol) and brine (10 vol). The obtained organic layer was dried over Na₂SO₄, filtered and solvent was removed under reduced pressure. The crude material was column purified. The product was eluted at 5-10% ethyl acetate/hexane to afford C₁₀-acid-TG-oleate Int-113 (60 mg, 30%) as viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 5.43 (m, 4H), 5.29 (m, 1H), 4.35 (d, 2H), 4.20 (m, 2H), 2.40 (m, 8H), 2.05 (m, 8H), 1.65 (m, 10H), 1.33-1.18 (m 46H), 0.93 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 1.78 (1C, C═O, 173.3 (2C, C═O), 172.8 (1C, C═O), 130.1 (2C), 129.8 (2C), 68.9 (C, CH), 62.1 (2C), 60.5 (2C), 34.2 (4C), 31.9 (2C), 29.8-29.0 (18C), 27.3 (4C), 24.9 (4C), 22.7 (2C), 14.2 (2C). HPLC (ELSD): 10.90 min, 99% purity. MS (ESI, +ve) m/z: 823.8 (MH⁺+H₂O).

Int-115 (1,3-DG-butyrate):

To a solution of 2,5-bis-(hydroxymethyl)-1,4-dioxane-2,5-diol (2.0 g, 1.11 mmol) in chloroform (40 ml) was added pyridine (2.2 mL, 2.77 mmol) followed by butyryl chloride (2.3 mL, 2.22 mol) before stirring at room temperature for 16 h. After completion, the solvent was evaporated and re-dissolved in ethyl acetate (60 ml) and washed with 1N HCl (20 ml). The combined organic layer was dried and evaporated under vacuum. The crude material was purified by column. The product was eluted at 5-10% ethyl acetate/hexane to afford Int-114 (1.4 g, 54%) as viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 4.8 (s, 4H), 2.45 (t, 4H), 1.79-1.69 (m, 4H), 1.04-0.98 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 198.2 (1C═O), 172.2 (2C═O), 66.1 (2C), 35.9 (2C), 18.3 (2C), 14.1 (2C). HPLC (ELSD): 1.73 min, 99.8% purity.

Sodium borohydride (NaBH₄, 230 mg, 6.10 mmol), was added to a solution of Int-114 (1.3 g, 6.1 mmol) in THF (26 ml) at 0° C. and then the reaction mixture was stirred at room temperature for 15 mins. The reaction was monitored by TLC and after completion, the reaction mixture was filtered through a celite bed to remove excess sodium borohydride, the celite bed was washed with ethyl acetate (40 ml), and the combined organic layer was washed with a 1N solution of acetic acid (13 ml). The organic layer was dried over Na₂SO₄ and solvent removed under vacuum. The crude material was purified by column. The product was eluted at 5-10% ethyl acetate/hexane to afford Int-115 (1.0 g, 70.6%) as a viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 4.25-4.13 (m, 5H), 2.4 (s, 1H), 2.38 (t, 4H), 1.75-1.66 (m, 4H), 1.01-0.98 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (2C═O), 68.3 (1C), 65.0 (2C), 35.9 (2C), 18.4 (2C), 13.6 (2C). HPLC (ELSD): 1.8 min, 100% purity. MS (ESI, +ve) m/z: 255.37 (M⁺+23).

Int-125:

Int-45 was prepared as described above and coupled with Int-115 using EDC and DMAP similarly to methods described above to provide Int-124. Int-124: ¹H NMR (401 MHz, CDCl₃) δ 7.70-7.64 (m, 4H), 7.42-7.35 (m, 6H), 5.29 (m, 1H), 4.307/4.305 (each dd, J=11.9, 4.2 Hz, 2H), 4.159/4.157 (each dd, J=11.9, 6.0 Hz, 2H), 3.66 (t, J=6.5 Hz, 2H), 2.34 (dd, J=14.7, 5.9 Hz, 1H), 2.30 (t, J=7.4 Hz, 4H), 2.13 (dd, J=14.7, 8.3 Hz, 1H), 1.95 (m, 1H), 1.70-1.50 (m, 6H), 1.37-1.17 (m, 20H), 1.05 (s, 9H), 0.95 (t, J=7.5 Hz, 6H). 0.94 (d, J=6.4 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.2 (2C; C), 172.5 (C), 135.7 (4C; CH), 134.3 (2C; C), 129.6 (2C; CH), 127.7 (4C; CH), 68.9 (CH), 64.1 (CH₂), 62.3 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 36.0 (2C; CH₂), 32.7 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.80 (3C; CH₂), 29.76 (CH₂), 29.75 (CH₂), 29.5 (CH₂), 27.1 (CH₂), 27.0 (3C; CH₃), 25.9 (CH₂), 19.7 (CH₃), 19.3 (C) 18.5 (2C; CH₂), 13.7 (2C; CH₃).

Int-125:

Tetrabutylammonium fluoride (TBAF, 1.0 M in THF, 243 μL, 0.243 mmol) and AcOH (13.9 L, 0.243 mmol) were added dropwise to TBDPS ether 3 (58.7 mg, 0.0809 mmol) in THF (4 mL) at 0° C. and the mixture stirred at rt for 19 hours. The reaction was diluted with water (10 mL) and the aqueous phase extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with sat. aq. NaHCO₃ and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (6% to 20% ethyl acetate/hexanes) gave alcohol Int-125 (26.7 mg, 68%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.28 (m, 1H), 4.298/4.295 (each dd, J=11.9, 4.3 Hz, 2H), 4.153/4.151 (each dd, J=11.9, 6.0 Hz, 2H), 3.64 (t, J=6.6 Hz, 2H), 2.33 (dd, J=14.7, 5.9 Hz, 1H), 2.30 (t, J=8.4, 6.5 Hz, 4H), 2.12 (dd, J=14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.70-1.46 (m, 8H), 1.38-1.16 (m, 18H), 0.95 (t, J=7.4 Hz, 6H), 0.93 (d, J=6.7 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.3 (2C; C), 172.5 (C), 69.0 (CH), 63.2 (CH₂), 62.3 (2C; CH₂), 41.9 (CH₂), 36.8 (CH₂), 36.1 (2C; CH₂), 33.0 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.78 (CH₂), 29.76 (2C; CH₂), 29.74 (CH₂), 29.71 (CH₂), 29.6 (CH₂), 27.1 (CH₂), 25.9 (CH₂), 19.7 (CH₃), 18.5 (2C; CH₂), 13.8 (2C; CH₃).

Int-126:

Prepared using similar methods as those shown above. ¹H NMR (401 MHz, CDCl₃) δ 5.23 (m, 1H), 4.26 (dd, J=11.9, 4.3 Hz, 2H), 4.11 (dd, J=11.9, 6.0 Hz, 2H), 3.36 (t, J=6.9 Hz, 2H), 2.28 (t, J=7.4 Hz, 2H), 2.26 (t, J=7.4 Hz, 4H), 1.84-1.75 (m, 2H), 1.66-1.52 (m, 6H), 1.42-1.33 (m, 2H), 1.31-1.19 (m, 12H), 0.90 (t, J=7.4 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.1 (2C; C), 172.9 (C), 68.9 (CH), 62.1 (2C; CH₂), 35.9 (2C; CH₂), 34.2 (CH₂), 34.0 (CH₂), 32.9 (CH₂), 29.5 (CH₂), 29.43 (CH₂), 29.42 (CH₂), 29.3 (CH₂), 29.1 (CH₂), 28.8 (CH₂), 28.2 (CH₂), 24.9 (CH₂), 18.4 (2C; CH₂), 13.7 (2C; CH₃); ESI-HRMS: calcd. for C₂₃H₄₁ ⁷⁹BrNaO₆ [M+Na⁺] 515.1979; found 515.1995.

Int-117 1,3-bis-decanoyl glycerol (1,3-DG-decanoate):

To a solution of 2, 5-bis-(hydroxymethyl)-1,4-dioxane-2,5-diol (0.2 g, 1.11 mmol) in chloroform (4.0 ml) was added pyridine (0.22 mL, 2.77 mmol) followed by decanoyl chloride (0.45 mL, 2.22 mmol) and stirred at room temperature for 16 h. The solvent was evaporated and re-dissolved in ethyl acetate (6 ml) and washed with 1N HCl (2 ml). The organic layer was dried and solvent evaporated under vacuum. The crude material was purified by column. The product was eluted at 5-10% ethyl acetate/hexane to afford Int-116 (0.09 g, 20.36%) as viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 4.8 (m, 4H), 2.46 (m, 4H), 1.73-1.66 (m, 4H), 1.30 (m, 24H), 0.91 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 198.2 (1C═O), 172.0 (2C═O), 66.1 (2C), 33.7 (2C), 31.8 (2C), 29.3 (2C), 29.2 (2C), 29.0 (2C), 24.8 (2C), 22.6 (2C), 14.12 (2C). HPLC (ELSD): 2.88 min, 100% purity.

Sodium borohydride (NaBH₄) (7 mg, 0.2 mmol), was added to a solution of Int-116 (80 mg, 0.2 mmol) in THF (2 ml) at 0° C. and then the reaction mixture was stirred at room temperature for 15 mins. The reaction was monitored by TLC and after completion, the reaction mixture was filtered through a celite bed to remove excess sodium borohydride and the celite bed was washed with ethyl acetate (3 ml). The organic layer was washed with 1 M acetic acid (1 ml). The solvent was dried over Na₂SO₄ and solvent removed under vacuum. The crude material was purified by column. The product was eluted at 5-10% ethyl acetate/hexane to afford Int-117 (70 mg, 100%) as viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 4.2-4.1 (m, 5H), 2.51 (s, 1H), 2.38 (t, 4H), 1.68-1.64 (m, 4H), 1.32-1.29 (m, 22H), 0.91 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.0 (2C═O), 68.3 (1C), 65.0 (2C), 34.1 (2C), 31.8 (2C), 29.7 (2C), 29.4 (2C), 29.3 (2C), 29.1 (2C), 24.9 (2C), 22.7 (2C), 14.1 (2C). HPLC (ELSD): 10.70 min, 97.6% purity.

Int-123:

Tetra-n-butyl ammonium hydrogen sulfate (0.034 g, 0.098 mmol) and potassium bicarbonate (0.198 g, 1.977 mmol) in distilled water (10 ml) was added to a stirred solution of Int-81 (0.4 g, 0.494 mmol) and tetra-n-butyl ammonium hydrogen sulfate (0.034 g, 0.098 mmol) in dichloromethane (10 ml) at rt and stirred for 0.5 h. Then chloromethyl chlorosulfate (0.062 ml, 0.618 mmol) was added dropwise at rt and stirred vigorously at rt for 18 h. The reaction was monitored by TLC, and after completion of reaction, the reaction mixture was diluted with DCM (25 ml). The organic phase was separated and the aqueous phase extracted with DCM (2×50 ml). Combined organic layers were washed with water (50 ml), brine (50 mL), dried over sodium sulphate, filtered and concentrated at reduced pressure to get crude material. Crude material was purified by column chromatography over silica 100-200 mesh; compound eluted at 20% ethyl acetate/hexane as a mobile phase; visualization was with KMnO₄ solution. Int-123 (0.250 g, 59%) was obtained as a viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 5.75 (m, 2H), 5.32-5.30 (m, 1H), 4.33 (dd, J=11.9, 4.3 Hz, 2H), 4.18 (dd, J=11.9, 6.0 Hz, 2H), 2.56-2.45 (m, 2H), 2.36-2.32 (t, J=7.2 Hz, 4H), 1.66-1.62 (m, 4H), 1.48-1.40 (m, 8H), 1.29 (m, 56H), 1.19 (dd, J=11.2, 7.0 Hz, 6H), 0.92 (t, J=6.7 Hz, 6H).

Example 2: Synthesis of (4-acetamidophenoxy)methyl (1,3-bis(palmitoyloxy)propan-2-yl) succinate, I-1

Synthesis of I-1. I-1 is prepared according to the following procedure. N-(4-((methylthio)methoxy)phenyl)acetamide, 1.1, is prepared by treating acetaminophen with chloromethyl methyl thioether as described in WO 2009/143295, which is hereby incorporated by reference in its entirety. A solution of sulfuryl chloride (2.2 equiv.) in CH₂Cl₂ (0.16 M) is added to a solution of 1.1 (1.8 equiv.) in CH₂Cl₂ (0.07 M) at 0° C. and the mixture stirred at 0° C. for 30 minutes and then at rt for a further hour. The reaction is concentrated under a stream of N2, co-evaporated from toluene (twice) and dried under reduced pressure. The crude residue is re-dissolved in toluene (0.1 M based on 1.1), added to a solution of acid 1.2 (1 equiv.), as prepared in WO 2017/041139, and DBU (1.5 equiv.) in toluene (0.05 M) that had been pre-stirred for one hour, and the mixture is stirred at rt for two hours. The reaction is diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ (20 mL) and brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography with a suitable solvent mixture affords I-1.

Example 3: Synthesis of (((4-acetamidophenoxy)carbonyl)oxy)methyl (1,3-bis(palmitoyloxy)propan-2-yl) succinate, 1-2

Synthesis of 2.2. 2.2 is prepared according to the following procedure. Chloromethyl chloroformate (1.6 equiv.) and pyridine (3.0 equiv.) are added to acetaminophen 2.1 (1.0 equiv.) in CH₂Cl₂ (0.03 M) at 0° C. and the mixture is stirred at 0° C. for 15 minutes and then at rt for one hour. The reaction is diluted with CH₂Cl₂ and the organic phase washed with sat. aq. NaHCO₃ and brine, dried (MgSO₄) and concentrated under reduced pressure to give 2.2 which is used without purification.

Synthesis of I-2. I-2 is prepared according to the following procedure. Silver carbonate (0.7 equiv.) is added to acid 2.3 (1.2 equiv.) as prepared in WO 2017/041139, in DMF (0.03 M) and the mixture stirred at rt for one hour. The reaction is concentrated under reduced pressure to give a grey residue, to which is added chloromethyl carbonate 2.2 (1.0 equiv.) in toluene (0.03 M) and TBAI (0.3 equiv.) and the mixture heated at reflux for 1.5 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography with a suitable solvent mixture affords 1-2.

Example 4: Synthesis of 2-(4-(4-acetamidophenoxy)-2-methyl-4-oxobutan-2-yl)-3,5-dimethylphenyl (1,3-bis(palmitoyloxy)propan-2-yl) succinate, 1-3

Synthesis of I-3. I-3 is prepared according to the following procedure. 4-(Dimethylamino)pyridine (DMAP, 1.3 equiv.) and EDC.HCl (2.1 equiv.) is added to a solution of acid 3.1 (1.0 equiv.) as prepared in WO 2017/041139, and acetaminophen 3.2 (1.3 equiv.) in CH₂Cl₂ (0.02 M) and the mixture stirred at rt for 19 hours. The reaction is diluted with CH₂Cl₂ (10 mL), silica gel is added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography with a suitable solvent mixture affords 1-3.

Example 5: Synthesis of 4-((((4-acetamidophenoxy)carbonyl)oxy)methyl)phenyl (1,3-bis(palmitoyloxy)propan-2-yl) succinate, 1-4

Synthesis of I-4. I-4 is prepared according to the following procedure. 4-(Dimethylamino)pyridine (DMAP, 1.3 equiv.) and DIPEA (0.3 equiv.) were added to a solution of acetaminophen, 4.1 (1.2 equiv.) and PNP carbonate 4.2 (1.0 equiv.) as prepared in WO 2017/041139, in CH₂Cl₂ (0.01 M) and the mixture stirred at rt for five days. The reaction was diluted with CH₂Cl₂, washed with 1 M HCl, water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography with a suitable solvent mixture affords 1-4.

Example 6: Synthesis of 4-(4-acetamidophenoxy)-4-oxobutyl (1,3-bis(palmitoyloxy)propan-2-yl) succinate (I-5) and Additional Paracetamol (Acetaminophen) Lipid Prodrugs

Synthesis of 5.3. 5.3 is prepared according to the following procedure. 4-(Dimethylamino)pyridine (1.3 equiv.) and DCC (2.1 equiv.) are added to a solution of acetaminophen (1.0 equiv.) and 4-bromobutyric acid 5.2 (1.3 equiv.) in CH₂Cl₂ (0.03 M) and the mixture is stirred at rt for 24 hours. Another 0.6 eq. of acid, 1 eq. of DCC, 0.6 eq. of DMAP are added and the mixture is stirred at rt for a further two days. The reaction is diluted with CH₂Cl₂, silica gel is added and the mixture is concentrated under reduced pressure. Purification by silica gel chromatography gives bromide 5.3.

Synthesis of I-5. I-5 is prepared according to the following procedure. 1,8-Diazabicyclo[5.4.0]undec-7-ene (DBU) (1.6 equiv.) is added to a suspension of acid 5.4 (1.1 equiv.) as prepared in WO 2017/041139, and bromide 5.3 (1.0 equiv.) in toluene (0.03 M) and the mixture is heated at reflux for 21 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography with a suitable solvent mixture affords 1-5.

Additional compounds were prepared according to methods similar to those described in this and the foregoing Examples. These compounds and their characterization data are shown below in Table 8.

TABLE 8 Additional Lipid Prodrugs of Paracetamol (Acetaminophen) Cmpd. # Structure ¹H NMR; ¹³C NMR; MS I-6 

¹H NMR (401 MHz, CDCl₃) δ 7.50 (d, J = 8.9 Hz, 2H), 7.15 (s, 1H), 7.03 (d, J = 8.9 Hz, 2H), 5.29 (m, 1H), 4.318/4.313 (each dd, J = 11.9, 4.2 Hz, 2H), 4.146/4.144 (each dd, J = 11.9, 6.0 Hz, 2H), 2.68-2.45 (m, 4H), 2.39-2.27 (m, 5H), 2.17 (s, 3H), 1.66-1.53 (m, 4H), 1.25 (s, 48H), 1.12 (d, J = 6.5 Hz, 3H), 0.88 (t, J = 6.8 Hz, 6H). I-7 

¹H NMR (401 MHz, CDCl₃) δ 7.49 (d, J = 8.8 Hz, 2H), 7.30 (br s, 1H), 7.02 (d, J = 8.8 Hz, 2H), 5.26 (m, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.53 (t, J = 7.5 Hz, 2H), 2.32 (t, J = 7.5 Hz, 2H), 2.31 (t, J = 7.5 Hz, 4H), 2.16 (s, 3H), 1.78-1.69 (m, 2H), 1.68-1.54 (m, 6H), 1.44-1.19 (m, 56H), 0.88 (t, J = 6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 173.0 (C), 172.5 (C), 168.3 (C), 147.1 (C), 135.6 (C), 122.1 (2C; CH), 120.9 (2C; CH), 69.0 (CH), 62.2 (2C, CH₂), 34.5 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.26 (2C; CH₂), 29.22 (CH₂), 29.20 (CH₂), 29.17 (CH₂), 29.12 (CH₂), 25.01 (2C; CH₂), 24.96 (CH₂), 24.7 (CH₃), 22.8 (2C; CH₂), 14.3 (2C; CH₃). I-8 

¹H NMR (401 MHz, CDCl₃) δ 7.49 (d, J = 8.9 Hz, 2H), 7.31 (br s, 1H), 7.01 (d, J = 8.9 Hz, 2H), 5.28 (m, 1H), 4.288/4.284 (each dd, J = 11.9, 4.3 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.66 (m, 1H), 2.32 (dd, J = 14.7, 5.8 Hz, 1H), 2.30 (t, J = 7.5 Hz, 4H), 2.16 (s, 3H), 2.12 (dd, J = 14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.79 (m, 1H), 1.68-1.47 (m, 6H), 1.45-1.15 (m, 62H), 0.93 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 175.6 (C), 173.5 (2C; C), 172.5 (C), 168.3 (C), 147.1 (C), 135.6 (C), 122.1 (2C; CH), 120.9 (2C; CH), 68.9 (CH), 62.3 (2C; CH₂), 41.8 (CH₂), 39.8 (CH), 36.8 (CH₂), 34.2 (2C; CH₂), 33.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.84 (7C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (4C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.4 (CH₂), 27.0 (CH₂), 25.0 (2C; CH₂), 24.6 (CH₃), 22.8 (2C; CH₂), 19.7 (CH₃), 17.2 (CH₃), 14.3 (2C; CH₃); ESI-HRMS: calcd. for C₅₇H₉₉NNaO₉ [M + Na⁺] 964.7212; found 964.7214. I-9 

¹H NMR (401 MHz, CDCl₃) δ 7.53 (d, J = 8.9 Hz, 2H), 7.20 (br s, 1H), 7.15 (d, J = 9.0 Hz, 2H), 5.85 (s, 2H), 5.27 (m, 1H), 4.33-4.27 (m, 2H), 4.13 (dd, J = 11.9, 6.0 Hz, 2H), 2.56- 2.24 (m, 9H), 2.18 (s, 3H), 1.67- 1.53 (m, 4H), 1.37-1.19 (m, 48H), 1.06 (d, J = 6.4 Hz, 3H), 0.88 (t, J = 6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 171.4 (C), 170.7 (C), 152.7 (C), 121.5 (2C; CH), 120.9 (2C; CH), 82.4 (CH₂), 69.4 (CH), 62.2 (2C; CH₂), 40.6 (CH₂), 40.3 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.3 (CH), 25.0 (2C; CH₂), 24.7 (CH₃), 22.8 (2C; CH₂), 19.8 (CH₃), 14.3 (2C; CH₃). I-10

¹H NMR (401 MHz, CDCl₃) δ 7.49 (d, J = 8.9 Hz, 2H), 7.41 (br s, 1H), 7.01 (d, J = 8.9 Hz, 2H), 5.26 (m, 1H), 4.288/4.281 (each dd, J = 11.9, 4.3 Hz, 2H), 4.16-4.09 (m, 4H), 2.58 (t, J = 7.1 Hz, 2H), 2.50-2.35 (m, 3H), 2.30 (t, J = 7.5 Hz, 4H), 2.33-2.20 (m, 2H), 2.15 (s, 3H), 1.86-1.71 (m, 4H), 1.65-1.54 (m, 4H), 1.34-1.18 (m, 48H), 1.02 (d, J = 6.5 Hz, 3H), 0.87 (t, J = 6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 172.3 (C), 172.0 (C), 171.5 (C), 168.4 (C), 146.9 (C), 135.8 (C), 122.0 (2C; CH), 120.9 (2C; CH), 69.2 (CH), 64.0 (CH₂), 62.2 (2C; CH₂), 40.8 (2C; CH₂), 34.12 (2C; CH₂), 33.9 (CH₂), 32.1 (2C; CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.2 (CH₂), 27.5 (CH), 25.0 (2C; CH₂), 24.6 (CH₃), 22.8 (2C; CH₂), 21.6 (CH₂), 19.8 (CH₃), 14.2 (2C; CH₃).

Example 7: Synthesis of Buprenorphine Lipid Prodrugs

Synthesis of I-12. DMAP (2.0 mg, 16.0 μmol) and EDC.HCl (7.7 mg, 40.0 μmol) were added to a solution of Int-28 (13.9 mg, 20.8 μmol) and buprenorphine (7.5 mg, 16.0 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at rt for two hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the solvent removed under reduced pressure. Purification by silica gel chromatography (10% to 15% ethyl acetate/hexanes with 0.5% Et₃N) gave BUP prodrug I-12 (15.6 mg, 87%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 6.78 (d, J=8.1 Hz, 1H), 6.58 (d, J=8.1 Hz, 1H), 5.89 (s, 1H), 5.26 (m, 1H), 4.42 (d, J=1.6 Hz, 1H), 4.29 (dt, J=11.9, 4.4 Hz, 2H), 4.19-4.12 (m, 2H), 3.45 (s, 3H), 3.05-2.97 (m, 2H), 2.93-2.83 (m, 3H), 2.70 (t, J=6.9 Hz, 2H), 2.62 (dd, J=11.8, 4.9 Hz, 1H), 2.37-2.20 (m, 8H), 2.11 (t, J=9.8 Hz, 1H), 1.96 (m, 1H), 1.91-1.75 (m, 2H), 1.70 (dd, J=13.0, 2.4 Hz, 1H), 1.65-1.53 (m, 4H), 1.35 (s, 3H), 1.37-1.16 (m, 49H), 1.06 (m, 1H), 1.03 (s, 9H), 0.88 (t, J=6.9 Hz, 6H), 0.80 (m, 1H), 0.67 (m, 1H), 0.54-0.42 (m, 2H), 0.15-0.08 (m, 2H).

Additional compounds were prepared according to methods similar to those described in this and the foregoing Examples. These compounds and their characterization data are shown below in Table 9.

TABLE 9 Additional Lipid Prodrugs of Buprenorphine Cmpd. # Structure ¹H NMR; ¹³C NMR; MS I-13

¹H NMR (401 MHz, CDCl₃) δ ¹H NMR (401 MHz, CDCl₃) δ 6.76 (d, J = 7.6 Hz, 1H), 6.59 (d, J = 8.1 Hz, 1H), 5.88 (s, 1H), 5.28 (m, 1H), 4.42 (s, 1H), 4.34-4.26 (m, 2H), 4.13 (dd, J = 11.9, 6.0 Hz, 2H), 3.45 (s, 3H), 3.06- 2.98 (m, 2H), 2.88 (m, 1H), 2.67- 2.59 (m, 2H), 2.57-2.41 (m, 3H), 2.39-2.21 (m, 9H), 2.11 (m, 1H), 2.02-1.78 (m, 3H), 1.71 (m, 1H), 1.65-1.54 (m, 4H), 1.35 (s, 3H), 1.38- 1.19 (m, 49H), 1.102/1.091 (each d, J = 6.4 Hz, 3H), 1.04 (m, 1H), 1.03 (s, 9H), 0.87 (t, J = 6.9 Hz, 8H), 0.79 (m, 1H), 0.70 (m, 1H), 0.55-0.42 (m, 2H), 0.15-0.08 (m, 2H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 171.4 (C), 170.1 (C), 149.9 (C), 134.6 (C), 133.9 (C), 131.3 (C), 122.1 (CH), 119.4 (CH), 98.2 (CH), 80.9 (C), 79.4 (C), 69.3 (CH), 62.2 (2C; CH₂), 59.7 (CH₂), 58.3 (CH), 52.7 (CH₃), 46.4 (C), 44.4 (CH), 43.7 (CH₂), 40.69/40.60 (CH₂), 40.5 (C), 40.36/40.32 (CH₂), 36.1 (C), 35.6 (CH₂), 34.1 (2C; CH₂), 33.5 (CH₂), 32.1 (2C; CH₂), 29.9 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.68/27.64 (CH), 26.6 (3C; CH₃), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 2.01 (CH₃), 19.62/19.60 (CH₃), 17.7 (CH₂), 14.3 (2C; CH₃), 9.6 (CH), 4.3 (CH₂), 3.4 (CH₂). I-14

¹H NMR (400 MHz, CDCl₃) δ 6.76 (d, J = 8.1 Hz, 1H), 6.59 (d, J = 8.1 Hz, 1H), 5.90 (s, 1H), 5.26 (m, 1H), 4.42 (d, J = 1.7 Hz, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 3.45 (s, 3H), 3.05-2.98 (m, 2H), 2.88 (m, 1H), 2.62 (dd, J = 11.8, 4.9 Hz, 1H), 2.51 (t, J = 7.5 Hz, 2H), 2.38-2.21 (m, 10H), 2.12 (m, 1H), 2.03-1.77 (m, 3H), 1.73-1.66 (m, 3H), 1.65-1.52 (m, 6H), 1.35 (s, 3H), 1.43-1.18 (m, 57H), 1.06 (m, 1H), 1.03 (s, 9H), 0.88 (t, J = 6.9 Hz, 6H), 0.80 (m, 1H), 0.68 (m, 1H), 0.54- 0.42 (m, 2H), 0.15-0.08 (m, 2H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.9 (C), 171.7 (C), 150.0 (C), 134.5 (C), 133.8 (C), 131.6 (C), 122.2 (CH), 119.4 (CH), 98.3 (CH), 80.9 (C), 79.4 (C), 69.0 (CH), 62.2 (2C; CH₂), 59.7 (CH₂), 58.3 (CH), 52.7 (CH₃), 46.4 (C), 44.5 (CH), 43.7 (CH₂), 40.5 (C), 36.1 (C), 35.6 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 33.5 (CH₂), 32.1 (2C; CH₂), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.25 (2C; CH₂), 29.23 (2C; CH₂), 29.15 (2C; CH₂), 26.6 (3C; CH₃), 25.2 (CH₂), 25.00 (2C; CH₂), 24.96 (CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.1 (CH₃), 17.6 (CH₂), 14.3 (2C; CH₃), 9.6 (CH), 4.3 (CH₂), 3.4 (CH₂). I-15

¹H NMR (401 MHz, CDCl₃) δ 6.79 (d, J = 1.8 Hz, 1H), 6.59 (d, J = 8.1 Hz, 1H), 6.57 (d, J = 1.4 Hz, 1H), 6.53 (d, J = 8.1 Hz, 1H), 5.90 (s, 1H), 5.28 (m, 1H), 4.39 (d, J = 1.4 Hz, 1H), 4.30 (dt, J = 11.9, 3.7 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 3.37 (s, 3H), 3.10- 2.95 (m, 4H), 2.87 (m, 1H), 2.70 (dd, J = 14.8, 5.0 Hz, 1H), 2.64-2.49 (m, 4H), 2.55 (s, 3H), 2.40-2.18 (m, 9H), 2.22 (s, 3H), 2.10 (t, J = 9.8 Hz, 1H), 1.97 (m, 1H), 1.88-1.73 (m, 2H), 1.71-1.53 (m, 11H), 1.35 (s, 3H), 1.44-1.19 (m, 49H), 1.13 (d, J = 6.3 Hz, 3H), 1.05 (m, 1H), 1.02 (s, 9H), 0.87 (t, J = 6.8 Hz, 6H), 0.79 (m, 1H), 0.66 (m, 1H), 0.53-0.42 (m, 2H), 0.15-0.07 (m, 2H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 171.4 (C), 171.3 (C), 169.4 (C), 150.0 (C), 149.5 (C), 138.2 (C), 136.4 (C), 134.4 (C), 133.7 (C), 133.5 (C), 132.6 (CH), 131.3 (C), 123.1 (CH), 122.3 (CH), 119.3 (CH), 98.1 (CH), 80.8 (C), 79.4 (C), 69.3 (CH), 62.2 (2C; CH₂), 59.6 (CH₂), 58.3 (CH), 52.7 (CH₃), 47.3 (CH₂), 46.3 (C), 44.3 (CH), 43.7 (CH₂), 41.3 (CH₂), 40.7 (CH₂), 40.5 (C), 39.0 (C), 36.1 (C), 35.5 (CH₂), 34.1 (2C; CH₂), 33.5 (CH₂), 32.1 (2C; CH₂), 31.4 (CH₃), 31.33/31.31 (CH₃), 29.9 (CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 27.3 (CH), 26.5 (3C; CH₃), 25.5 (CH₃), 25.0 (2C; CH₂), 23.4 (CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 20.1 (CH₃), 19.9 (CH₃), 17.7 (CH₂), 14.3 (2C; CH₃), 9.6 (CH), 4.3 (CH₂), 3.4 (CH₂). I-16

¹H NMR (401 MHz, CDCl₃) δ 6.78 (d, J = 8.1 Hz, 1H), 6.59 (d, J = 8.1 Hz, 1H), 5.89 (s, 1H), 5.27 (m, 1H), 4.42 (d, J = 1.7 Hz, 1H), 4.299/4.296 (each dd, J = 11.9, 4.3 Hz, 2H), 4.20-4.09 (m, 4H), 3.45 (s, 3H), 3.06-2.98 (m, 2H), 2.88 (m, 1H), 2.67-2.58 (m, 3H), 2.52-2.20 (m, 13H), 2.19-1.78 (m, 6H), 1.70 (dd, J = 13.2, 5.5 Hz, 1H), 1.66-1.49 (m, 4H), 1.35 (s, 3H), 1.38-1.17 (m, 49H), 1.04 (m, 1H), 1.03 (s, 9H), 1.02 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.9 Hz, 6H), 0.80 (m, 1H), 0.68 (m, 1H), 0.54-0.43 (m, 2H), 0.16-0.08 (m, 2H). I-17

¹H NMR (401 MHz, CDCl₃) δ 6.88 (d, J = 8.2 Hz, 1H), 6.60 (d, J = 8.1 Hz, 1H), 5.86 (s, 1H), 5.82 (s, 2H), 5.27 (m, 1H), 4.46 (s, 1H), 4.30 (dd, J = 12.0, 4.3 Hz, 2H), 4.15 (dd, J = 12.0, 5.9 Hz, 2H), 3.49 (s, 3H), 3.06-2.98 (m, 2H), 2.89 (m, 1H), 2.73-2.60 (m, 5H), 2.39-2.22 (m, 8H), 2.12 (t, J = 9.2 Hz, 1H), 2.01 (m, 1H), 1.93-1.80 (m, 2H), 1.75-1.49 (m, 5H), 1.35 (s, 3H), 1.34-1.20 (m, 49H), 1.05 (m, 1H), 1.03 (s, 9H), 0.88 (t, J = 6.9 Hz, 6H), 0.80 (m, 1H), 0.66 (m, 1H), 0.56- 0.44 (m, 2H), 0.16-0.09 (m, 2H); ESI-HRMS: Calcd. for C₇₀H₁₁₄NO₁₄ [M + H⁺] 1192.8234; found 1192.8244. I-18

¹H NMR (401 MHz, CDCl₃) δ 6.87 (d, J = 8.2 Hz, 1H), 6.60 (d, J = 8.2 Hz, 1H), 5.89 (s, 1H), 5.81 (ddd, J = 8.5, 5.6, 2.5 Hz, 2H), 5.27 (m, 1H), 4.46 (s, 1H), 4.285/4.283 (each dd, J = 11.9, 4.3 Hz, 2H), 4.14 (dd, J = 11.8, 5.9 Hz, 2H), 3.48 (s, 3H), 3.07-2.97 (m, 2H), 2.89 (m, 1H), 2.63 (dd, J = 11.9, 4.8 Hz, 1H), 2.47 (m, 1H), 2.41-2.22 (m, 9H), 2.16-2.06 (m, 2H), 2.03- 1.77 (m, 4H), 1.75-1.50 (m, 7H), 1.48-1.20 (m, 61H), 1.35 (s, 3H), 1.172/1.167 (each d, J = 7.0 Hz, 3H), 1.05 (m, 1H), 1.03 (s, 9H), 0.92 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.9 Hz, 6H), 0.80 (m, 1H), 0.67 (m, 1H), 0.54- 0.43 (m, 2H), 0.15-0.08 (m, 2H). I-19

¹H NMR (401 MHz, CDCl₃) δ 6.88/6.87 (each d, J = 8.2 Hz, 1H), 6.77 (m, 1H), 6.59 (d, J = 8.2 Hz, 1H), 5.89/5.88 (each s, 1H), 5.25 (m, 1H), 4.46 (br s, 1H), 4.33-4.26 (m, 2H), 4.19-4.11 (m, 2H), 3.49/3.48 (each s, 3H), 3.06-2.98 (m, 2H), 2.89 (m, 1H), 2.74-2.57 (m, 5H), 2.38-2.20 (m, 8H), 2.12 (t, J = 10.0 Hz, 1H), 1.98 (td, J = 12.5, 5.5 Hz, 1H), 1.91-1.77 (m, 2H), 1.70 (dd, J = 13.4, 2.9 Hz, 1H), 1.64-1.52 (m, 7H), 1.35 (s, 3H), 1.33-1.18 (m, 49H), 1.06 (m, 1H), 1.03 (s, 5H), 0.88 (t, J = 6.9 Hz, 6H), 0.81 (m, 1H), 0.66 (m, 1H), 0.55- 0.43 (m, 2H), 0.15-0.07 (m, 2H); ESI-HRMS: Calcd. for C₇₁H₁₁₆NO₁₄ [M + H⁺] 1206.8390; found 1206.8401.

Example 8: Synthesis of BODIPY and Cy5 Lipid Prodrugs

DMAP (2.9 mg, 24.1 μmol) and EDC.HCl (11.5 mg, 60.2 μmol) were added to a solution of 1,3-diglyceride Int-2 (13.7 mg, 24.1 μmol) and BODIPY-558 acid (10.0 mg, 28.9 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at rt for 18 hours. The reaction was concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (7.5% to 9% ethyl acetate/hexanes) gave BODIPY-TG I-11 (8.0 mg, 37%) as a purple solid. ¹H NMR (401 MHz, CDCl₃) δ 8.16 (dd, J=3.9, 1.0 Hz, 1H), 7.50 (dd, J=5.1, 1.0 Hz, 1H), 7.18 (dd, J=5.0, 3.9 Hz, 1H), 7.12 (s, 1H), 7.04 (d, J=4.4 Hz, 1H), 6.97 (d, J=4.1 Hz, 1H), 6.80 (d, J=4.2 Hz, 1H), 6.38 (d, J=4.1 Hz, 1H), 5.28 (m, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=12.1, 5.8 Hz, 2H), 3.37 (t, J=7.4 Hz, 2H), 2.82 (t, J=7.4 Hz, 2H), 2.29 (t, J=7.6 Hz, 4H), 1.65-1.52 (m, 4H), 1.37-1.19 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (C), 171.7 (C), 131.5 (CH), 130.8 (CH), 129.7 (CH), 129.2 (CH), 126.8 (CH), 120.6 (CH), 118.8 (CH), 114.2 (CH), 69.6 (CH), 62.2 (2C; CH₂), 34.2 (2C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 29.85 (2C; CH₂), 29.81 (2C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.0 (2C; CH₂), 24.1 (CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₃). Note: All five aromatic quaternary carbon signals were too weak to be observed, while several of the aromatic CH signals were also relatively weak.

DMAP, 2.2 mg, 18.0 μmol) and EDC.HCl (8.6 mg, 44.9 μmol) were added to a solution of 1,3-diglyceride Int-2 (10.2 mg, 18.0 μmol) and cyanine-5 acid 1 (9.8 mg, 18.9 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at rt for two days and 21 hours. The reaction was concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (1% to 4% MeOH/CH₂Cl₂) gave Cy5-TG I-22 (6.5 mg, 35%) as a blue solid. ¹H NMR (401 MHz, CDCl₃) δ 8.19 (t, J=11.9 Hz, 2H), 7.41-7.31 (m, 4H), 7.29-7.18 (m, 2H), 7.13-7.02 (m, 2H), 6.92 (t, J=12.5 Hz, 1H), 6.40 (dd, J=13.5, 3.5 Hz, 2H), 5.23 (m, 1H), 4.30 (dd, J=11.9, 4.4 Hz, 2H), 4.17-4.02 (m, 4H), 3.71 (s, 3H), 2.38 (t, J=7.4 Hz, 2H), 2.31 (t, J=7.5 Hz, 4H), 1.78 (s, 6H), 1.74 (s, 6H), 1.88-1.49 (m, 10H), 1.39-0.98 (m, 48H), 0.91-0.84 (m, 6H).

Example 9: Synthesis of Cannabidiol Lipid Prodrugs

Lipid prodrugs of cannabidiol (CBD) were synthesized as follows.

DMAP (2.7 mg, 22.3 μmol) and EDC.HCl (10.7 mg, 55.6 μmol) were added to a solution of triglyceride intermediate Int-4 (18.6 mg, 26.7 μmol) and cannabidiol (7.0 mg, 22.3 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at rt for 19 hours. The reaction was then concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (5% to 7.5% to 10% ethyl acetate/hexanes gave CBD prodrug CBD-C5bMe-2-TG (I-20) (9.9 mg, 45%); ¹H NMR (401 MHz, CDCl₃) δ 6.55 (s, 1H), 6.38 (dd, J=3.4, 1.7 Hz, 1H), 5.97 (br s, 1H), 5.52 (br s, 1H), 5.28 (m, 1H), 4.60 (m, 1H), 4.44 (br s, 1H), 4.36-4.27 (m, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.47 (m, 1H), 2.67-2.27 (m, 8H), 2.30 (t, J=7.6 Hz, 4H), 2.21 (m, 1H), 2.06 (m, 1H), 1.86-1.67 (m, 5H), 1.65-1.51 (m, 9H), 1.47-1.19 (m, 52H), 1.11 (d, J=6.5 Hz, 3H), 0.88 (t, J=6.8 Hz, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 173.43 (2C; C), 171.44/171.41 (C), 170.68/170.66 (C), 69.34 (CH), 62.20 (2C; CH₂), 45.73 (CH), 40.78 (CH₂), 40.64 (CH₂), 40.58 (CH₂), 38.14 (CH), 35.54 (CH₂), 34.16 (2C; CH₂), 32.07 (2C; CH₂), 31.63 (CH₂), 30.67 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.63 (2C; CH₂), 29.51 (2C; CH₂), 29.42 (2C; CH₂), 29.27 (2C; CH₂), 27.42 (CH), 24.99 (2C; CH₂), 23.76 (CH₃), 22.84 (2C; CH₂), 22.64 (CH₂), 19.88/19.85 (CH₃), 14.27 (2C; CH₃), 14.17 (CH₃). Note: i) 37% of bis-prodrug (i.e. coupling of C₁₀-acid-TG to both phenolic hydroxyl groups of cannabidiol) was also isolated; ii) A number of the aromatic signals were not observed in the ¹³C NMR spectrum.

Compound CBD-FSI5-C5bMe-2-TG (I-21) was prepared as follows.

Intermediate 2 in the scheme above was prepared as follows. DMAP (5.2 mg, 42.9 μmol) and tert-butyl(chloro)diphenylsilane (TBDPSCl, 7.4 μL, 28.6 μmol) were added to a solution of cannabidiol (1) (9.0 mg, 28.6 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at rt for 23 hours. An additional amount of TBDPS (4.9 μL, 19.1 mol) was added and the mixture stirred at rt for a further seven hours. The reaction was concentrated under a stream of N2 to give the crude product. Purification by silica gel chromatography (2% to 3% ethyl acetate/hexanes) gave mono-TBDPS ether 2 (2.6 mg, 16%) as a colorless oil; ¹H NMR (401 MHz, CDCl₃) δ 7.76-7.71 (m, 2H), 7.62 (d, J=6.9 Hz, 2H), 7.47-7.27 (m, 6H), 6.18 (br s, 1H), 5.90 (br s, 1H), 5.77 (d, J=1.5 Hz, 1H), 5.58 (br s, 1H), 4.67 (m, 1H), 4.57 (s, 1H), 4.23 (m, 1H), 2.57 (m, 1H), 2.31-2.10 (m, 2H), 2.07 (t, J=7.4 Hz, 2H), 1.92-1.74 (m, 2H), 1.80 (s, 3H), 1.62 (s, 3H), 1.15-0.99 (m, 4H), 1.07 (s, 9H), 0.97-0.86 (m, 2H), 0.74 (t, J=7.3 Hz, 3H).

Intermediate 3 in the scheme above was prepared as follows. DMAP (0.7 mg, 5.8 μmol) and EDC.HCl (3.3 mg, 17.4 μmol) were added to a solution of phenol 2 (3.2 mg, 5.8 μmol) and 5-bromovaleric acid (2.1 mg, 11.6 μmol) in CH₂Cl₂ (0.6 mL) and the mixture stirred at rt for 19 hours. The reaction was concentrated under a stream of N2 gas to give the crude product. Purification by silica gel chromatography (4% to 5% ethyl acetate/hexanes) gave bromovalerate ester 3 (3.1 mg, 76%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 7.76-7.56 (m, 4H), 7.46-7.30 (m, 6H), 6.28 (d, J=1.5 Hz, 1H), 6.05 (s, 1H), 5.24 (m, 1H), 4.61 (s, 2H), 4.22 (m, 1H), 3.46 (t, J=6.5 Hz, 2H), 2.76 (m, 1H), 2.60-2.14 (m, 4H), 2.13-1.94 (m, 6H), 1.93-1.71 (m, 4H), 1.67 (s, 3H), 1.62 (s, 3H), 1.32-1.24 (m, 2H), 1.07 (s, 9H), 1.12-1.01 (m, 2H), 0.97-0.83 (m, 2H), 0.73 (t, J=7.3 Hz, 3H).

Intermediate 5 in the scheme above was prepared as follows. Silver carbonate (2.7 mg, 9.7 μmol) was added to a solution of acid-TG Int-4 (10.2 mg, 14.6 μmol) and bromide 3 (8.7 mg, 12.2 μmol) in toluene (1 mL) and the mixture heated at 80° C. for one hour and at reflux for a further 1.5 hours. The reaction was cooled to rt, tetra-n-butylammonium iodide (TBAI, 4.5 mg, 12.2 μmol) was added and the mixture heated at reflux for an additional hour. The reaction was re-cooled to rt, diluted with ethyl acetate (40 mL) and the organic phase washed with water and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (5% to 12.5% ethyl acetate/hexanes) gave protected CBD prodrug 1-21 (9.8 mg, 60%) as a colourless oil. ¹H NMR (401 MHz, CDCl₃) δ 7.76-7.56 (m, 4H), 7.47-7.29 (m, 6H), 6.28 (d, J=1.5 Hz, 1H), 6.05 (s, 1H), 5.27 (m, 1H), 4.61 (br s, 1H), 4.300/4.296 (each dd, J=11.9, 4.3 Hz, 2H), 4.26-4.07 (m, 4H), 2.76 (m, 1H), 2.60-2.36 (m, 5H), 2.31 (t, J=7.5 Hz, 4H), 2.28-2.18 (m, 2H), 2.17-2.02 (m, 2H), 1.89-1.70 (m, 6H), 1.66 (s, 3H), 1.64-1.53 (m, 9H), 1.38-1.18 (m, 52H), 1.07 (s, 9H), 1.03 (d, J=6.5 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H), 0.73 (t, J=7.3 Hz, 3H); ESI-HRMS: Calcd. for C₈₃H₁₃₁O₁₁Si [M+H⁺] 1331.9455; found 1331.9417.

Example 10: Synthesis of Raloxifene, Rasagiline, Testosterone, Tetrahydrocannabinol (THC), and Other Lipid Prodrugs

Additional lipid prodrugs were prepared using methods similar to those described herein.

TABLE 10 Additional Lipid Prodrugs Cmpd. # Structure ¹H NMR; ¹³C NMR; MS I-23

¹H NMR (400 MHz, CDCl₃) δ 7.77 (d, J = 8.8 Hz, 1H), 7.66 (d, J = 8.9 Hz, 2H), 7.59 (d, J = 2.1 Hz, 1H), 7.19 (d, J = 8.6 Hz, 2H), 7.08 (dd, J = 8.8, 2.2 Hz, 1H), 6.67 (d, J = 7.3 Hz, 2H), 6.61 (d, J = 8.6 Hz, 2H), 5.26 (m, 1H), 4.30 (dd, J = 11.9, 4.3 Hz, 2H), 4.15 (dd, J = 11.9, 5.9 Hz, 2H), 4.09 (t, J = 5.7 Hz, 2H), 2.77 (t, J = 5.8 Hz, 2H), 2.62-2.50 (m, 6H), 2.37-2.27 (m, 6H), 1.82- 1.73 (m, 2H), 1.69-1.55 (m, 10H), 1.50-1.19 (m, 58H), 0.87 (t, J = 6.8 Hz, 6H); ESI-HRMS: calcd. for C₇₃H₁₁₀NO₁₁S [M + H⁺] 1208.7794; found 1208.7815. I-24

¹H NMR (400 MHz, CDCl₃) δ 7.76- 7.71 (m, 2H), 7.49 (d, J = 8.8 Hz, 1H), 7.42-7.38 (m, 2H), 7.28 (d, J = 2.1 Hz, 1H), 6.97-6.93 (m, 2H), 6.87 (dd, J = 8.8, 2.3 Hz, 1H), 6.77- 6.71 (m, 2H), 5.25 (m, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.27- 4.19 (m, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.97 (br s, 2H), 2.72 (br s, 4H), 2.51 (t, J = 7.5 Hz, 2H), 2.32 (t, J = 7.5 Hz, 2H), 2.31 (t, J = 7.6 Hz, 4H), 1.84-1.49 (m, 10H), 1.42- 1.19 (m, 58H), 0.88 (t, J = 6.9 Hz, 6H). I-25

¹H NMR (400 MHz, CDCl₃) δ 7.79 (d, J = 8.8 Hz, 1H), 7.64 (d, J = 8.9 Hz, 2H), 7.60 (d, J = 2.0 Hz, 1H), 7.16 (d, J = 8.6 Hz, 2H), 7.09 (dd, J = 8.8, 2.2 Hz, 1H), 6.65 (d, J = 8.9 Hz, 2H), 6.61 (d, J = 8.6 Hz, 2H), 5.31 (m, 1H), 4.331/4.328 (each dd, J = 11.9, 4.2 Hz, 2H), 4.16 (dd, J = 12.1, 5.7 Hz, 3H), 4.13 (t, J = 5.5 Hz, 2H), 2.83 (t, J = 5.2 Hz, 2H), 2.71 (dd, J = 14.8, 5.5 Hz, 1H), 2.67- 2.48 (m, 7H), 2.39 (dd, J = 15.3, 7.2 Hz, 1H), 2.310/2.308 (each t, J = 7.8 Hz, 4H), 1.71-1.64 (m, 4H), 1.63-1.55 (m, 4H), 1.53-1.43 (m, 2H), 1.37-1.19 (m, 48H), 1.16 (d, J = 6.5 Hz, 3H), 0.87 (t, J = 6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 192.8 (C), 173.5 (2C; C), 171.4 (C), 171.0 (C), 162.0 (C), 157.5 (C), 148.0 (C), 139.1 (C), 137.8 (C), 132.5 (2C; CH), 131.0 (2C; CH), 130.2 (C), 125.1 (C), 124.4 (CH), 119.7 (CH), 116.1 (2C; CH), 114.7 (CH), 114.4 (2C; CH), 69.4 (CH), 65.2 (CH₂), 62.2 (2C; CH₂), 57.2 (CH₂), 55.0 (2C; CH₂), 40.8 (2C; CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.6 (CH), 25.0 (2C; CH₂), 24.7 (CH₂), 23.3 (CH₂), 22.8 (2C; CH₂), 19.9 (CH₃), 14.3 (2C; CH₃); ESI-HRMS: calcd. for C₆₉H₁₀₂NO₁₁S [M + H⁺] 1152.7168; found 1152.7186. I-26

¹H NMR (400 MHz, CDCl₃) δ 7.72 (d, J = 8.9 Hz, 2H), 7.65 (d, J = 8.8 Hz, 1H), 7.63 (d, J = 1.9 Hz, 1H), 7.46-7.40 (m, 2H), 7.08 (dd, J = 8.8, 2.2 Hz, 1H), 7.01-6.96 (m, 2H), 6.77 (d, J = 8.9 Hz, 2H), 5.30 (m, 1H), 4.331/4.327 (each dd, J = 11.9, 4.2 Hz, 2H), 4.18-4.13 (m, 4H), 2.88-2.77 (m, 2H), 2.71 (dd, J = 14.8, 5.5 Hz, 1H), 2.66-2.48 (m, 7H), 2.39 (dd, J = 15.3, 7.1 Hz, 1H), 2.309/2,307 (each t, J = 7.8 Hz, 4H), 2.26 (s, 3H), 1.70-1.54 (m, 8H), 1.51-1.41 (m, 2H), 1.34- 1.19 (m, 48H), 1.16 (d, J = 6.5 Hz, 3H), 0.87 (t, J = 6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 192.6 (C), 173.4 (2C; C), 171.4 (C), 170.9 (C), 169.1 (C), 163.2 (C), 151.1 (C), 148.3 (C), 144.4 (C), 139.5 (C), 137.7 (C), 132.5 (2C; CH), 131.8 (C), 130.9 (C), 130.4 (C), 130.3 (2C; CH), 124.4 (CH), 122.0 (2C; CH), 119.8 (CH), 114.8 (CH), 114.5 (2C; CH), 69.5 (CH), 66.0 (CH₂), 62.2 (2C; CH₂), 57.6 (CH₂), 55.1 (2C; CH₂), 40.7 (2C; CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.6 (CH), 25.6 (2C; CH₂), 25.0 (2C; CH₂), 24.0 (CH₂), 22.8 (2C; CH₂), 21.3 (CH₃), 19.9 (CH₃), 14.3 (2C; CH₃); ESI-HRMS: calcd. for C₇₁H₁₀₄NO₁₂S [M + H⁺] 1194.7274; found 1194.7285. I-27

¹H NMR (401 MHz, CDCl₃) δ 7.77- 7.71 (m, 2H), 7.68-7.61 (m, 2H), 7.46-7.41 (m, 2H), 7.08 (dd, J = 8.8, 2.2 Hz, 1H), 7.00-6.94 (m, 2H), 6.81-6.74 (m, 2H), 5.30 (m, 1H), 4.332/4.329 (each dd, J = 11.9, 4.2 Hz, 2H), 4.24-4.11 (m, 4H), 2.89-2.68 (m, 5H), 2.66- 2.48 (m, 6H), 2.39 (dd, J = 15.3, 7.1 Hz, 1H), 2.311/2.307 (each t, J = 7.7 Hz, 4H), 1.73-1.41 (m, 10H), 1.36-1.20 (m, 48H), 1.28 (d, J = 7.0 Hz, 6H), 1.16 (d, J = 6.5 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 192.7 (C), 175.3 (C), 173.4 (2C; C), 171.4 (C), 170.9 (C), 151.4 (C), 148.3 (C), 139.5 (C), 137.7 (C), 132.5 (2C; CH), 131.7 (C), 130.7 (C), 130.3 (2C; CH), 124.4 (CH), 122.0 (2C; CH), 119.8 (CH), 114.8 (CH), 114.5 (2C; CH), 69.5 (CH), 62.2 (2C; CH₂), 40.8 (2C; CH₂), 34.3 (CH), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.6 (CH), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 19.9 (CH₃), 19.0 (2C; CH₃), 14.3 (2C; CH₃). Note: Some signals were not observed in the ¹³C NMR spectrum. I-28

¹H NMR (401 MHz, CDCl₃) δ 7.77- 7.71 (m, 2H), 7.63 (d, J = 8.9 Hz, 1H), 7.60 (d, J = 1.9 Hz, 1H), 7.38- 7.33 (m, 2H), 7.06 (dd, J = 8.8, 2.2 Hz, 1H), 6.79-6.74 (m, 4H), 5.30 (m, 1H), 4.330/4.227 (each dd, J = 11.9, 4.2 Hz, 2H), 4.19-4.10 (m, 4H), 3.76 (s, 3H), 2.84-2.76 (m, 2H), 2.71 (dd, J = 14.8, 5.5 Hz, 1H), 2.66-2.48 (m, 6H), 2.38 (dd, J = 15.3, 7.1 Hz, 1H), 2.310/2.306 (each t, J = 7.6 Hz, 4H), 1.76-1.54 (m, 9H), 1.51-1.42 (m, 2H), 1.35- 1.18 (m, 48H), 1.16 (d, J = 6.5 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 193.0 (C), 173.5 (2C; C), 171.4 (C), 171.0 (C), 160.2 (C), 148.0 (C), 145.6 (C), 139.2 (C), 137.9 (C), 132.5 (2C; C), 130.54 (2C; C), 130.48 (C), 125.8 (C), 124.1 (CH), 119.6 (CH), 114.8 (CH), 114.4 (2C; CH), 114.3 (2C; CH), 69.4 (CH), 66.0* (CH₂), 62.2 (2C; CH₂), 57.7 (CH₂), 55.4 (CH₃), 55.1 (CH₂), 40.7 (2C; CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.6 (CH), 25.7* (2C; CH₂), 25.0 (2C; CH₂), 24.0* (CH₂), 22.8 (2C; CH₂), 19.9 (CH₃), 14.3 (2C; CH₃). Note: Two signals were missing from the ¹³C NMR spectrum, possibly the quaternary signals of the thiophene ring, while the signals marked with an asterisk (*) were very weak/broad and their presence was supported by cross- peaks in the HSQC spectrum. I-29

¹H NMR (401 MHz, CDCl₃) δ 7.75 (d, J = 8.9 Hz, 2H), 7.51 (d, J = 8.9 Hz, 1H), 7.43 (d, J = 8.7 Hz, 2H), 7.33 (d, J = 2.3 Hz, 1H), 7.00-6.93 (m, 3H), 6.77 (d, J = 9.0 Hz, 2H), 5.27 (m, 1H), 4.29 (dd, J = 11.9, 4.2 Hz, 2H), 4.18-4.09 (m, 4H), 3.89 (s, 3H), 2.84-2.75 (m, 2H), 2.62- 2.47 (m, 6H), 2.33 (dd, J = 14.7, 5.8 Hz, 1H), 2.30 (t, J = 7.5 Hz, 4H), 2.12 (dd, J = 14.7, 8.3 Hz, 1H), 1.94 (m, 1H), 1.75-1.56 (m, 9H), 1.50- 1.16 (m, 59H), 0.93 (d, J = 6.6 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 193.1 (C), 173.4 (2C; C), 172.4 (C), 172.0 (C), 158.0 (C), 150.9 (C), 140.5 (C), 134.0 (C), 132.5 (2C; CH), 131.8 (C), 131.2 (C), 130.5 (C), 130.2 (2C; CH), 124.4 (CH), 121.9 (2C; CH), 115.2 (CH), 114.4 (2C; CH), 104.6 (CH), 69.0 (CH), 65.9* (CH₂), 62.3 (2C; CH₂), 57.6 (CH₂), 55.8 (CH₂), 55.1 (2C; CH₂), 41.8 (CH₂), 36.8 (CH₂), 34.5 (CH₂), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (2C; CH₂), 29.55 (CH₂), 29.51 (2C; CH₂), 29.42 (2C; CH₂), 29.27 (2C; CH₂), 29.23 (CH₂), 26.9 (CH₂), 25.6* (2C; CH₂), 25.00 (2C; CH₂), 24.97 (CH₂), 23.9* (CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 14.3 (2C; CH₃). Note: One signals was missing from the ¹³C NMR spectrum, possibly one of the quaternary signals from the thiophene ring, while the signals marked with an asterisk (*) were very weak/broad and their presence was supported by cross-peaks in the HSQC spectrum. I-30

¹H NMR (400 MHz, CDCl₃) δ 7.14 (m, 4H), 6.31 (m, 1H), 5.6 (m, 2H), 5.4 (m, 2H) 4.30 (m. 4H), 4.2 (m, 4H), 3.91 (m, 1H), 3.70 (m, 1H), 3.4 (m, 1H), 3.08 (m, 2H), 2.56 (m, 4H), 2.36 (m, 10H), 1.74 (m, 3H), 1.64 (m, 6H), 1.37 (m, 44H), 0.93 (t, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.9 (1C, C═O), 173.3 (2C, C═O), 172.9 (1C, C═O), 144.2-143.3 (2C), 141.03-140.229 (2C), 128.45-128.0 (2C), 126.99-126.72 (2C), 125.33- 125.05 (2C), 124.34-123.92 (2C), 81.13-80.60 (2C), 71.78 (1C), 69.85 (1C), 68.88 (2C), 63.29 (1C), 62.10 (2C), 59.36 (1C), 34.04-33.86 (4C), 33.20 (2C), 31.96-31.63 (2C), 30.64-30.08 (2C), 29.73-29.04 (13), 25.40-25.18 (2C), 24.8 (2C), 22.74 (2C), 14.18 (2C). HPLC (ELSD): 14.67 min, 100% purity; HPLC (Chiral): 6.71 min, 100% purity; MS (ESI, +ve) m/z: 907.5 (MH⁺ + 1). I-31

¹H NMR (400 MHz, CDCl₃) δ 7.33 (d, J = 8.3 Hz, 1H), 7.31-7.16 (m, 3H), 7.11-7.07 (m, 1H), 6.99- 6.88 (m, 2H), 6.85-6.77 (m, 1H), 5.54-5.46 (m, 0.6H), 5.33-5.22 (m, 1.4H), 4.43-4.24 (m, 2H), 4.18 (br s, 1H), 4.15-4.09 (m, 2H), 2.72- 2.66 (m, 3H), 2.55-2.36 (m, 3H), 2.34-2.20 (m, 7H), 2.06-1.97 (m, 1H), 1.84-1.70 (m, 2H), 1.64- 1.49 (m, 7H), 1.37-1.16 (m, 48H), 1.07/1.02 (each d, J = 6.4 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H); Note: Fractional integrations, doubled signals and the lack of well-defined signals were observed due to the presence of diastereomers and/or rotational isomers. ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (C), 69.2 (CH), 62.2 (2C; CH₂), 34.1 (2C; CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 14.3 (2C; CH₂). Note: Only the signals for the glyceride portion are listed—multiple signals are observed in almost all other cases. I-32

¹H NMR (400 MHz, CDCl₃): δ 5.72 (s, 1H), 5.26 (m, 1H), 4.61 (dd, J = 9.0, 7.9 Hz, 1H), 4.291/4.288 (each dd, J = 11.9, 4.3, 1.3 Hz, 2H), 4.15 (dd, J = 12.1, 6.0 Hz, 2H), 2.68- 2.58 (m, 4H), 2.47-2.24 (m, 4H), 2.31 (t, J = 7.6 Hz, 4H), 2.17 (m, 1H), 2.02 (m, 1H), 1.84 (m, 1H), 1.78 (m, 1H), 1.73-1.44 (m, 9H), 1.42-1.13 (m, 51H), 1.18 (s, 3H), 1.12-0.91 (m, 3H), 0.87 (t, J = 6.9 Hz, 6H), 0.83 (s, 3H); ¹³C NMR (100 MHz, CDCl₃): δ 199.6 (C), 173.5 (2C; C), 172.1 (C), 171.6 (C), 171.1 (C), 124.1 (CH), 83.0 (CH), 69.6 (CH), 62.0 (2C; CH₂), 53.8 (CH), 50.3 (CH), 42.7 (C), 38.7 (C), 36.7 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.14 (2C; CH₂), 34.05 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.42 (2C; CH₂), 29.26 (2C; CH₂), 29.25 (CH₂), 29.22 (CH₂), 27.6 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 20.6 (CH₂), 17.5 (CH₃), 14.3 (2C; CH₃), 12.2 (CH₃); ESI-HRMS: calcd. for C₅₉H₁₀₁O₉ [M + H⁺] 953.7440; found 953.7452. I-33

¹H NMR (401 MHz, CDCl₃) δ 5.73 (s, 1H), 5.25 (m, 1H), 4.61 (dd, J = 8.1, 8.1 Hz, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.47-2.14 (m, 12H), 2.09 (dd, J = 14.5, 8.2 Hz, 1H), 2.02 (ddd, J = 13.1, 4.7, 3.2 Hz, 1H), 1.92 (m, 1H), 1.85 (m, 1H), 1.78 (m, 1H), 1.74-1.46 (m, 11H), 1.44- 1.21 (m, 58H), 1.19 (s, 3H), 1.18- 0.96 (m, 4H), 0.93 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.9 Hz, 6H), 0.83 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.5 (C), 173.42 (2C; C), 173.39/173.37 (C), 172.9 (C), 171.0 (C), 124.1 (CH), 82.3 (CH), 69.1 (CH), 62.2 (2C; CH₂), 53.9 (CH), 50.4 (CH), 42.6 (C), 42.23/42.22 (CH₂), 38.8 (C), 36.84 (CH₂), 36.81 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.3 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 30.59/30.55 (CH), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (2C; CH₂), 29.59 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 29.2 (CH₂), 27.68/27.65 (CH₂), 26.9 (CH₂), 25.01 (2C; CH₂), 24.99 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.85/19.83 (CH₃), 17.6 (CH₃), 14.3 (2C; CH₃), 12.2 (CH₃). I-34

¹H NMR (401 MHz, CDCl₃) δ 5.73 (s, 1H), 5.27 (m, 1H), 4.61 (m, 1H), 4.289/4.287 (each dd, J = 11.7, 4.2 Hz, 2H), 4.14 (d, J = 11.9, 6/0 Hz, 2H), 2.47-2.24 (m, 10H), 2.23- 2.08 (m, 2H), 2.02 (m, 1H), 1.93 (m, 1H), 1.86 (m, 1H), 1.80-1.76 (m, 1H), 1.72-1.46 (m, 10H), 1.44- 1.22 (m, 64H), 1.19 (s, 3H), 1.139/1.132 (each d, J = 7.0 Hz, 3H), 1.11-0.95 (m, 3H), 0.93 (d, J = 6.6 Hz, 3H), 0.88 (d, J = 6.9 Hz, 6H), 0.84 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 176.9 (C), 173.4 (2C; C), 172.5 (C), 171.0 (C), 124.1 (CH), 82.1 (CH), 69.0 (CH), 62.3 (2C; CH₂), 53.9 (CH), 50.5 (CH), 42.7 (C), 41.9 (CH₂), 39.93/39.88 (CH), 38.8 (C), 36.9 (CH₂), 36.8 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 34.00/33.96 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.7 (CH₂), 30.5 (CH), 29.92 (CH₂), 29.85 (2C; CH₂), 29.81 (2C; CH₂), 29.78 (2C; CH₂), 29.70 (CH₂), 29.69 (CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.68/27.66 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.1 (2C; CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.7 (CH₃), 17.6 (CH₃), 17.42/17.26 (CH₃), 14.3 (2C; CH₃), 12.23/12.21 (CH₃). I-35

¹H NMR (401 MHz, CDCl₃) δ 5.73 (s, 1H), 5.27 (m, 1H), 4.61/4.60 (each dd, J = 9.1, 7.8 Hz, 1H), 4.28 (dd, J = 11.9, 3.8 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.47-2.24 (m, 10H), 2.18 (m, 1H), 2.11 (dd, J = 14.7, 8.3 Hz, 1H), 2.02 (m, 1H), 1.93 (m, 1H), 1.85 (m, 1H), 1.77 (m, 1H), 1.73-1.54 (m, 9H), 1.52- 1.21 (m, 71H), 1.19 (s, 3H), 1.133/1.126 (each d, J = 7.0 Hz, 3H), 1.11-0.94 (m, 3H), 0.92 (d, J = 6.6 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H), 0.84 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 177.0 (C), 173.4 (2C; C), 172.5 (C), 171.1 (C), 124.1 (CH), 82.10/82.08 (CH), 69.0 (CH), 62.3 (2C; CH₂), 53.9 (CH), 50.4 (CH), 42.7 (C), 41.8 (CH₂), 39.90/39.87 (CH), 38.7 (C), 36.84 (CH₂), 36.79 (CH₂), 35.8 (CH₂), 35.6 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 34.01/33.97 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 30.5 (CH), 30.0 (CH₂), 29.83 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (3C; CH₂), 29.68 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (3C; CH₂), 29.4 (2C; CH₂), 29.3 (3C; CH₂), 27.7 (CH₂), 27.6 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 17.4/17.3 (CH₃), 14.3 (2C; CH₃), 12.20/12.18 (CH₃). I-36

¹H NMR (401 MHz, CDCl₃) δ 5.74 (d, J = 8.6 Hz, 1H), 5.73 (s, 1H), 4.60 (dd, J = 8.9, 8.1 Hz, 1H), 4.46 (m, 1H), 4.22 (dd, J = 11.4, 5.4 Hz, 2H), 4.07 (dd, J = 11.4, 5.3 Hz, 2H), 2.47-2.23 (m, 10H), 2.22-2.12 (m, 3H), 2.02 (m, 1H), 1.85 (m, 1H), 1.77 (m, 1H), 1.73-1.45 (m, 13H), 1.43-1.21 (m, 58H), 1.19 (s, 3H), 1.16-0.90 (m, 4H), 0.88 (t, J = 6.8 Hz, 6H), 0.83 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 174.0 (C), 173.9 (2C; C), 173.0 (C), 171.1 (C), 124.1 (CH), 82.3 (CH), 62.8 (2C; CH₂), 53.9 (CH), 50.4 (CH), 47.6 (CH), 42.7 (C), 38.8 (C), 36.84 (CH₂), 36.80 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.7 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 29.85 (2C; CH₂), 29.81 (2C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.32 (2C; CH₂), 29.30 (2C; CH₂), 29.24 (2C; CH₂), 27.7 (CH₂), 25.7 (CH₂), 25.2 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 17.5 (CH₂), 14.3 (2C; CH₂), 12.2 (CH₂). I-37

¹H NMR (401 MHz, CDCl₃) δ 5.73 (s, 1H), 4.61 (dd, J = 9.0, 7.9 Hz, 1H), 4.18 (dd, J = 11.6, 4.9 Hz, 2H), 4.12 (dd, J = 11.4, 5.4 Hz, 2H), 3.67 (m, 1H), 3.54 (t, J = 6.6 Hz, 2H), 2.48-2.25 (m, 9H), 2.18 (m, 1H), 2.01 (m, 1H), 1.83 (m, 1H), 1.77 (m, 1H), 1.73-1.49 (m, 16H), 1.48- 1.22 (m, 58H), 1.19 (s, 3H), 1.17- 0.92 (m, 4H), 0.88 (t, J = 6.9 Hz, 6H), 0.84 (s, 3H); ¹³C NMR (101 Hz, CDCl₃) δ 199.6 (C), 174.0 (C), 173.7 (2C; C), 171.1 (C), 124.1 (CH), 82.3 (CH), 75.3 (CH), 70.8 (CH₂), 63.2 (2C; CH₂), 53.9 (CH), 50.4 (CH), 42.7 (C), 38.8 (C), 36.8 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.7 (CH₂), 34.3 (2C; CH₂), 34.1 (CH₂), 32.9 (CH2), 32.1 (2C; CH₂), 31.6 (CH₂), 30.1 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (2C; CH₂), 29.59 (CH₂), 29.56 (CH₂), 29.50 (2C; CH₂), 29.43 (2C; CH₂), 29.40 (CH₂), 29.29 (3C; CH2), 27.7 (CH₂), 26.1 (CH₂), 25.2 (CH₂), 25.1 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 17.5 (CH₃), 14.3 (2C; CH₃), 12.2 (CH₃). I-38

¹H NMR (400 MHz, CDCl₃) δ 5.73 (s, 1H), 5.33-5.22 (m, 3H), 4.30 (dd, J = 11.9, 4.4 Hz, 2H), 4.13 (dd, J = 11.9, 5.9 Hz, 2H), 3.54 (dd, J = 8.3, 8.3 Hz, 1H), 2.48-2.23 (m, 12H), 2.08-1.79 (m, 6H), 1.75- 1.50 (m, 9H), 1.49-1.21 (m, 49H), 1.19 (s, 3H), 1.17-0.83 (m, 5H), 0.88 (t, J = 6.9 Hz, 6H), 0.80 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 172.4 (C), 172.1 (C), 171.2 (C), 124.1 (CH), 89.6 (CH), 89.3 (CH₂), 69.4 (CH), 62.1 (2C; CH₂), 54.0 (CH), 50.4 (CH), 42.8 (C), 38.8 (C), 36.9 (CH₂), 35.9 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 33.4 (CH₂), 33.2 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.3 (CH₂), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.9 (CH₂), 17.5 (CH₃), 14.3 (2C; CH₃), 11.8 (CH₃). I-39

¹H NMR (400 MHz, CDCl₃) δ 5.73 (s, 1H), 5.32-5.21 (m, 3H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 3.55 (dd, J = 8.3, 8.3 Hz, 1H), 2.48-2.23 (m, 11H), 2.11 (dd, J = 14.9, 8.2 Hz, 1H), 2.07-1.99 (m, 2H), 1.98- 1.80 (m, 3H), 1.74-1.51 (m, 11H), 1.49-1.21 (m, 57H), 1.19 (s, 3H), 1.17-0.95 (m, 5H), 0.94 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.8 Hz, 6H), 0.80 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 172.94 (C), 172.90 (C), 171.2 (C), 124.1 (CH), 89.3 (CH), 89.0 (CH₂), 69.1 (CH), 62.2 (2C; CH₂), 54.0 (CH), 50.5 (CH), 42.8 (C), 42.17/42.16 (CH₂), 38.8 (C), 37.0 (CH₂), 36.8 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.3 (CH₂), 34.2 (2C; CH₂), 34.1 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.7 (CH₂), 30.29/30.28 (CH), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.63 (2C; CH₂), 29.57 (CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 29.2 (CH₂), 28.2 (CH₂), 26.9 (CH₂), 25.01 (2C; CH₂), 24.98 (CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.8 (CH₃), 17.5 (CH₃), 14.3 (2C; CH₃), 11.8 (CH₃). I-40

¹H NMR (401 MHz, CDCl₃) δ 5.72 (s, 1H), 5.32-5.23 (m, 3H), 4.28 (dd, J = 11.9, 4.0 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 3.55 (dd, J = 8.3, 8.3 Hz, 1H), 2.47-2.23 (m, 10H), 2.11 (dd, J = 14.7, 8.3 Hz, 1H), 2.07-1.98 (m, 2H), 1.95- 1.87 (m, 2H), 1.83 (m, 1H), 1.71 (m, 1H), 1.66-1.51 (m, 9H), 1.49- 1.35 (m, 2H), 1.49-1.35 (m, 60H), 1.19-0.85 (m, 5H), 1.18 (s, 3H), 1.15 (d, J = 7.0 Hz, 3H), 0.92 (d, J = 6.6 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H), 0.80 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 176.5 (C), 173.4 (2C; C), 172.4 (C), 171.2 (C), 124.1 (CH), 89.27/89.23 (CH), 89.00/88.97 (CH₂), 69.0 (CH), 62.3 (2C; CH₂), 54.1 (CH), 50.5 (CH), 42.8 (C), 41.8 (CH₂), 39.9 (CH), 38.8 (C), 37.0 (CH₂), 36.8 (CH₂), 35.9 (CH₂), 35.6 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 33.7 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.7 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.69 (CH₂), 29.68 (CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.27 (CH₂), 28.26 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 17.10/17.08 (CH₃), 14.3 (2C; CH₃), 11.8 (CH₃). I-41

¹H NMR (401 MHz, CDCl₃) δ 5.72 (s, 1H), 5.31-5.22 (m, 3H), 4.28 (dd, J = 11.9, 4.2 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 3.55 (dd, J = 8.3, 8.3 Hz, 1H), 2.47-2.23 (m, 10H), 2.11 (dd, J = 14.7, 8.3 Hz, 1H), 2.07-1.98 (m, 2H), 1.96- 1.78 (m, 3H), 1.73-1.52 (m, 11H), 1.18 (s, 3H), 1.49-1.06 (m, 68H), 1.15 (d, J = 7.0 Hz, 3H), 1.13-0.94 (m, 4H), 0.92 (d, J = 6.6 Hz, 3H), 0.87 (t, J = 6.8 Hz, 6H), 0.80 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 176.5 (C), 173.4 (2C; C), 172.4 (C), 171.2 (C), 124.0 (CH), 89.18/89.16 (CH₂), 88.94/88.92 (CH), 68.9 (CH), 62.3 (2C; CH₂), 54.0 (CH), 50.4 (CH), 42.7 (C), 41.8 (CH₂), 39.86/39.84 (CH), 38.8 (C), 36.9 (CH₂), 36.8 (CH₂), 35.9 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 33.7 (CH₂), 32.9 (CH₂), 32.0 (2C; CH₂), 31.6 (CH₂), 30.5 (CH), 30.0 (CH₂), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.74 (3C; CH₂), 29.70 (CH₂), 29.69 (CH₂), 29.60 (2C; CH₂), 29.48 (3C; CH₂), 29.39 (2C; CH₂), 29.24 (3C; CH₂), 28.22/28.21 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.4 (CH₂), 22.8 (2C; CH₂), 20.7 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 17.09/17.06 (CH₃), 14.2 (2C; CH₃), 11.7 (CH₃). I-42

¹H NMR (401 MHz, CDCl₃) δ 5.75 (s, 2H), 5.73 (s, 1H), 5.26 (m, 1H), 4.54 (dd, J = 9.0, 7.8 Hz, 1H), 4.301/4.296 (each dd, J = 11.9, 4.3 Hz, 2H), 4.13 (dd, J = 11.9, 6.0 Hz, 2H), 2.52-2.16 (m, 14H), 2.02 (ddd, J = 13.3, 4.8, 3.2 Hz, 1H), 1.90-1.80 (m, 2H), 1.75-1.55 (m, 9H), 1.47-1.17 (m, 51H), 1.19 (s, 3H), 1.04 (d, J = 6.4 Hz, 3H), 1.11- 0.90 (m, 3H), 0.88 (t, J = 6.7 Hz, 6H), 0.86 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 171.4 (C), 170.87 (C), 170.85 (C), 154.0 (C), 124.2 (CH), 87.1 (CH), 81.9 (CH₂), 69.3 (CH), 62.2 (2C; CH₂), 53.8 (CH), 50.2 (CH), 42.7 (C), 40.6 (CH₂), 40.3 (CH₂), 38.7 (C), 36.6 (CH₂), 35.9 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.4 (CH₂), 27.2 (CH), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.6 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 14.3 (2C; CH₃), 12.1 (CH₃). I-43

¹H NMR (401 MHz, CDCl₃) δ 5.77- 5.71 (m, 3H), 5.26 (m, 1H), 4.55 (dd, J = 8.8, 8.0 Hz, 1H), 4.28 (dd, J = 11.9, 4.3 Hz, 2H), 4.13 (dd, J = 11.9, 5.9 Hz, 2H), 2.47 (m, 1H), 2.43-2.17 (m, 10H), 2.11 (dd, J = 13.8, 7.5 Hz, 1H), 2.01 (ddd, J = 14.9, 10.7, 6.8 Hz, 1H), 1.92 (m, 1H), 1.88-1.81 (m, 2H), 1.75- 1.55 (m, 4H), 1.47-1.12 (m, 26H), 1.18 (s, 3H), 1.16 (d, J = 7.0 Hz, 3H), 1.11-0.94 (m, 1H), 0.92 (d, J = 6.6 Hz, 1H), 0.88 (d, J = 6.7 Hz, 2H), 0.85 (s, 1H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 175.4 (C), 173.4 (2C; C), 172.5 (C), 170.9 (C), 154.1 (C), 124.2 (CH), 87.0 (CH), 82.0 (CH₂), 69.0 (CH), 62.3 (2C; CH₂), 53.8 (CH), 50.2 (CH), 42.8 (C), 41.8 (CH₂), 39.4 (CH), 38.7 (CH), 36.8 (CH₂), 36.7 (CH₂), 35.9 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 33.5 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 30.5 (CH), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (3C; CH₂), 29.5 (3C; CH₂), 29.4 (2C; CH₂), 29.3 (3C; CH₂), 27.4 (CH₂), 27.2 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.6 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 16.83/16.81 (CH₃), 14.3 (2C; CH₃), 12.1 (CH₃). I-44

¹H NMR (401 MHz, CDCl₃) δ 6.75 (qd, J = 5.4, 2.4 Hz, 1H), 5.73 (s, 1H), 5.26 (m, 1H), 4.53 (dd, J = 14.4, 8.0 Hz, 1H), 4.33-4.26 (m, 2H), 4.132/4.130 (each dd, J = 11.9, 5.9 Hz, 2H), 2.51-2.15 (m, 14H), 2.02 (m, 1H), 1.91-1.81 (m, 2H), 1.75-1.55 (m, 9H), 1.512/1.509 (each d, J = 5.4 Hz, 3H), 1.47-1.20 (m, 50H), 1.19 (s, 3H), 1.03 (d, J = 6.2 Hz, 3H), 1.11- 0.84 (m, 4H), 0.87 (t, J = 7.1 Hz, 6H), 0.85 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.5 (C), 173.4 (2C; C), 171.4 (C), 170.88/170.86 (C), 170.33/170.29/170.27 (C), 153.22/153.19 (C), 124.2 (CH), 91.4 (CH), 86.76/86.68 (CH), 69.3 (CH), 62.2 (2C; CH₂), 53.8 (CH), 50.2 (CH), 42.80/42.72 (C), 40.69/40.63/40.61 (CH₂), 40.58/40.55/40.47/40.44 (CH₂), 38.74 (C), 36.69/36.65 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.38/27.35 (CH₂), 27.3 (CH), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.66/20.63 (CH₂), 19.7 (CH₃), 19.60/19.57 (CH₃), 17.5 (CH₃), 14.3 (2C; CH₃), 12.08/12.04 (CH₃). Note: Doubled/multiple signals were observed in some cases due to the presence of diastereomers. I-45

¹H NMR (401 MHz, CDCl₃) δ 6.747/6.741 (each q, J = 5.5 Hz, 1H), 5.73 (s, 1H), 5.25 (m, 1H), 4.535/4.527 (each dd, J = 9.0, 7.7 Hz, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 2.48-2.19 (m, 13H), 2.03 (m, 1H), 1.93-1.80 (m, 2H), 1.75-1.54 (m, 12H), 1.511/1.507 (each d, J = 5.4 Hz, 3H), 1.47-1.20 (m, 59H), 1.19 (s, 3H), 1.12-0.90 (m, 4H), 0.88 (t, J = 7.0 Hz, 6H), 0.86 (s, 3H). Note: Doubled signals were observed in some cases due to the presence of diastereomers. I-46

¹H NMR (401 MHz, CDCl₃) δ 6.73 (qd, J = 5.4, 2.6 Hz, 1H), 5.72 (s, 1H), 5.26 (m, 1H), 4.52 (m, 1H), 4.28 (dd, J = 11.9, 4.3 Hz, 2H), 4.13 (dd, J = 11.6, 6.2 Hz, 2H), 2.47- 2.15 (m, 12H), 2.10 (dd, J = 14.7, 8.3 Hz, 1H), 2.01 (m, 1H), 1.96- 1.79 (m, 3H), 1.75-1.53 (m, 11H), 1.501/1.498 (each d, J = 5.4 Hz, 3H), 1.46-1.20 (m, 58H), 1.18 (s, 3H), 1.10-0.92 (m, 4H), 0.92 (d, J = 6.0 Hz, 3H), 0.87 (t, J = 6.9 Hz, 6H), 0.85 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 172.4 (C), 171.8 (C), 170.9 (C), 153.2 (C), 124.1 (CH), 91.3 (CH), 86.68/86.62 (CH), 69.0 (CH), 62.3 (2C; CH₂), 53.8 (CH), 50.2 (CH), 42.78/42.71 (C), 41.8 (CH₂), 38.7 (C), 36.7 (CH₂), 36.67/36.65 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.2 (3C; CH₂), 34.0 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.5 (CH₂), 30.4 (CH), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.75 (2C; CH₂), 29.60 (2C; CH₂), 29.52 (CH₂), 29.49 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 29.13/29.11 (CH₂), 27.38/27.33 (CH₂), 26.86/26.85 (CH₂), 25.0 (2C; CH₂), 24.69/24.66 (CH₂), 23.4 (CH₂), 22.8 (2C; CH₂), 20.64/20.61 (CH₂), 19.7 (CH₃), 19.6 (CH₃), 17.5 (CH₃), 14.2 (2C; CH₃), 12.06/12.03 (CH₃). Note: Doubled signals was observed in some cases due to the presence of diastereomers. I-47

¹H NMR (401 MHz, CDCl₃) δ 6.74 (m, 1H), 5.73 (s, 1H), 5.27 (m, 1H), 4.53 (m, 1H), 4.29 (dd, J = 11.9, 4.3 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 2.48-2.25 (m, 10H), 2.20 (m, 1H), 2.11 (m, 1H), 2.02 (m, 1H), 1.97-1.80 (m, 3H), 1.77-1.54 (m, 10H), 1.51 (d, J = 5.4 Hz, 3H), 1.48- 1.20 (m, 63H), 1.19 (s, 3H), 1.16- 1.12 (m, 3H), 1.11-0.94 (m, 4H), 0.92 (d, J = 6.6 Hz, 3H), 0.88 (t, J = 6.6 Hz, 6H), 0.85 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 174.9 (C), 173.4 (2C; C), 172.5 (C), 170.9 (c), 153.2 (C), 124.2 (CH), 91.4 (CH), 86.6 (CH), 69.0 (CH), 62.3 (2C; CH₂), 53.8 (CH), 50.2 (CH), 41.8 (CH₂), 39.5 (CH), 36.9 (CH₂), 36.7 (CH₂), 35.9 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 33.6 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 30.5 (CH), 29.85 (7C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.67 (2C; CH₂), 29.63 (2C; CH₂), 29.51 (2C; CH₂), 29.42 (2C; CH₂), 29.27 (2C; CH₂), 27.5- 27.1 (3C; CH₂), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.6 (CH₂), 19.69 (CH₃), 19.67 (CH₃), 17.53 (CH₃), 16.9/16.8 (CH₃), 14.3 (2C; CH₃), 12.1 (CH₃). Note: Doubled signals were observed in some cases due to the presence of diastereomers. I-48

[α]^(D) ₂₇ + 42.0 (c 0.340, CH₂Cl₂); ¹H NMR (400 MHz, CDCl₃) δ 6.80 (d, J = 1.9 Hz, 1H), 6.56 (d, J = 1.8 Hz, 1H), 5.72 (s, 1H), 5.28 (m, 1H), 4.45 (dd, J = 9.1, 7.3 Hz, 1H), 4.32 (dd, J = 11.9, 4.4 Hz, 2H), 4.15 (dd, J = 11.9, 5.8 Hz, 2H), 2.79 (ABq, J = 14.5 Hz, 2H), 2.64 (t, J = 7.4 Hz, 2H), 2.54 (s, 3H), 2.49 (t, J = 7.1 Hz, 2H), 2.44-2.24 (m, 8H), 2.22 (s, 3H), 2.11-1.96 (m, 4H), 1.81 (m, 1H), 1.70 (dd, J = 13.7, 5.1 Hz, 1H), 1.65-1.48 (m, 8H), 1.55 (s, 6H), 1.44-1.18 (m, 51H), 1.17 (s, 3H), 1.11-0.92 (m, 4H), 0.88 (t, J = 6.9 Hz, 6H), 0.65 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 172.1 (C), 171.88 (C), 171.85 (C), 171.1 (C), 149.6 (C), 138.2 (C), 136.3 (C), 133.6 (C), 132.5 (CH), 124.1 (CH), 123.1 (CH), 82.5 (CH), 69.5 (CH), 62.1 (2C; CH₂), 53.8 (CH), 50.2 (CH), 48.2 (CH₂), 42.4 (C), 39.2 (C), 38.7 (C), 36.5 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.2 (2C; CH₂), 34.1 (CH₂), 34.0 (CH₂), 33.2 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.66 (CH₃), 31.60 (CH₂), 31.58 (CH₃), 29.84 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.4 (CH₂), 25.4 (CH₃), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 20.6 (CH₂), 20.4 (CH₃), 19.9 (CH₂), 17.5 (CH₃), 14.3 (2C; CH₃), 12.0 (CH₃); ESI-HRMS: calcd. for C₇₂H₁₁₆NaO₁₁ [M + Na⁺] 1179.8410; found 1179.8461; purity (LC-MS): >99% TST prodrug. I-49

¹H NMR (400 MHz, CDCl₃) δ 5.72 (s, 1H), 5.25 (m, 1H), 4.60 (dd, J = 9.0, 7.9 Hz, 1H), 4.29/4.28 (each dd, J = 11.9, 4.3 Hz, 2H), 4.12 (dd, J = 12.0, 5.9 Hz, 2H), 4.07 (t, J = 5.8 Hz, 2H), 2.49-2.09 (m, 12H), 2.29 (t, J = 7.4 Hz, 4H), 2.01 (m, 1H), 1.83 (m, 1H), 1.76 (m, 1H), 1.72-1.43 (m, 13H), 1.43-1.19 (m, 50H), 1.18 (s, 3H), 1.15-0.88 (m, 4H), 1.01 (d, J = 6.5 Hz, 3H), 0.86 (t, J = 6.8 Hz, 6H), 0.82 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 173.4 (2C; C), 173.3 (C), 172.3 (C), 171.5 (C), 171.1 (C), 124.1 (CH), 82.5 (CH), 69.2 (CH), 64.0 (CH₂), 62.2 (2C; CH₂), 53.8 (CH), 50.3 (CH), 42.6 (C), 40.78 (CH₂), 40.77 (CH₂), 38.7 (C), 36.8 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.1 (2C; CH₂), 34.0 (2C; CH₂), 32.8 (CH₂), 32.0 (2C; CH₂), 31.6 (CH₂), 29.81 (6C; CH₂), 29.77 (4C; CH₂), 29.73 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 28.2 (CH₂), 27.6 (CH₂), 27.5 (CH), 24.9 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 21.6 (CH₂), 20.6 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 14.2 (2C; CH₃), 12.2 (CH₃). I-50

¹H NMR (401 MHz, CDCl₃) δ 5.72 (s, 1H), 5.27 (m, 1H), 4.61 (dd, J = 9.0, 7.9 Hz, 1H), 4.28 (dd, J = 11.9, 3.7 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 4.10-4.03 (m, 2H), 2.47- 2.25 (m, 13H), 2.17 (m, 1H), 2.11 (dd, J = 14.7, 8.4 Hz, 1H), 2.02 (ddd, J = 13.3, 4.8, 3.2 Hz, 1H), 1.93 (m, 1H), 1.84 (m, 1H), 1.80- 1.55 (m, 17H), 1.53-1.21 (m, 72H), 1.19 (s, 4H), 1.13 (d, J = 7.0 Hz, 3H), 1.10-0.95 (m, 3H), 0.92 (d, J = 6.6 Hz, 4H), 0.87 (t, J = 6.7 Hz, 6H), 0.83 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199.6 (C), 177.0 (C), 173.43 (2C; C), 173.37 (C), 172.5 (C), 171.0 (C), 124.1 (CH), 82.5 (CH), 69.0 (CH), 63.8 (CH₂), 62.3 (2C; CH₂), 53.8 (CH), 50.4 (CH), 42.7 (C), 41.8 (CH₂), 39.7 (CH), 38.7 (C), 36.84 (CH₂), 36.79 (CH₂), 35.8 (CH₂), 35.5 (CH), 34.18 (2C; CH₂), 34.11 (CH₂), 34.06 (CH₂), 33.9 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.70 (CH₂), 29.67 (CH₂), 29.61 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.3 (CH₂), 27.7 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 21.7 (CH₂), 20.7 (CH₂), 19.7 (CH₃), 17.5 (CH₃), 17.2 (CH₃), 14.3 (2C; CH₃), 12.2 (CH₃). I-51

¹H NMR (400 MHz, CDCl₃) δ 5.77 (s, 1H), 5.39 (m, 6H), 4.66 (d, 1H), 4.35 (m, 2H), 4.20 (m, 2H), 2.46 (m, 6H), 2.39 (m, 8H), 2.2 (m, 2H), 2.05 (m, 8H), 1.8 (m, 4H), 1.66 (m, 8H), 1.4 (m, 54H), ¹³C NMR (101 MHz, CDCl₃) δ 199 (1C), 173.3 (2C), 172.8 (1C), 170.98 (1C), 130.02 (2C) 123.9 (1C), 82.1 (1C), 68.87 (1C), 62.12 (1C), 53.69 (1C), 50.23 (1C), 42.4 (1C), 38.6 (1C), 36.6 (1C) 35.6 (2C), 34.5 (6C), 32.7 (2C), 31.9 (2C), 29.7 (30C), 27.5 (3C), 25.05 (2C), 23.49 (2C), 22.6 (2C), 20.5 (1C), 17.3 (1C), 14.1 (2C), 12.0 (1C); HPLC (ELSD): 9.17 min, 99.33% purity; MS (ESI, +ve) m/z: 1.77 (MH⁺ + 1). I-52

¹H NMR (400 MHz, CDCl₃) δ 5.77 (s, 1H), 5.39 (m, 1H), 4.66 (d, 1H), 4.35 (m, 2H), 4.20 (m, 2H), 2.46 (m, 12H), 2.39 (m, 2H), 2.08 (m, 2H), 1.9 (m, 2H), 1.8 (m, 2H), 1.7 (m, 6H), 1.52 (m, 5H) 1.4 (m, 10H), 1.3 (m, 3H), 1.2 (m, 2H), 1.02 (m, 6H), 0.87 (s, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 199 (1C), 173.3 (2C), 172.9 (1C), 171.03 (1C), 123.9 (1C), 82.2 (1C), 68.9 (1C), 62.08 (2C), 53.72 (1C), 50.26 (1C), 42.53 (1C), 38.6 (1C), 36.6 (1C) 35.7 (3C), 34.5 (1C), 33.9 (1C), 32.7 (1C), 31.5 (1C), 29.1 (4C), 27.4 (2C), 25.08 (1C), 24.8 (2C), 23.52 (1C), 20.5 (1C), 18.38 (2C), 17.43 (1C), 13.67 (2C), 12.1 (1C); HPLC (ELSD): 2.62 min, 100% purity; LCMS (ESI, +ve) m/z: 687.7 (MH⁺ + 1). I-53

¹H NMR (401 MHz, CDCl₃) δ 6.54 (d, J = 1.7 Hz, 1H), 6.38 (d, J = 1.7 Hz, 1H), 5.95 (m, 1H), 5.26 (m, 1H), 4.29 (dd, J = 11.9, 4.4 Hz, 2H), 4.14 (dd, J = 11.9, 5.9 Hz, 2H), 3.05 (m, 1H), 2.54 (t, J = 7.5 Hz, 2H), 2.51- 2.46 (m, 2H), 2.32 (t, J = 7.5 Hz, 2H), 2.31 (td, J = 7.5 Hz, 4H), 2.16- 2.10 (m, 2H), 1.90 (m, 1H), 1.79- 1.71 (m, 2H), 1.65 (s, 3H), 1.70- 1.53 (m, 9H), 1.40 (s, 3H), 1.44- 1.20 (m, 61H), 1.08 (s, 3H), 0.91- 0.85 (m, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 173.0 (C), 171.6 (C), 154.6 (C), 149.5 (C), 142.8 (C), 134.7 (C), 123.6 (CH), 115.31 (CH), 115.25 (C), 114.1 (CH), 77.6 (C), 69.1 (CH), 62.2 (2C; CH₂), 45.7 (CH), 35.6 (CH₂), 34.6 (CH₂), 34.31 (CH₂), 34.28 (CH), 34.2 (2C; CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 31.2 (CH₂), 30.7 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.78 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.32 (CH₂), 29.31 (CH₂), 29.29 (CH₂), 29.27 (2C; CH₂), 29.2 (CH₂), 27.6 (CH₃), 25.1 (CH₂), 25.01 (2C; CH₂), 25.00 (CH₂), 24.96 (CH₂), 23.5 (CH₃), 22.8 (2C; CH₂), 22.7 (CH₂), 19.5 (CH₃), 14.3 (2C; CH₃), 14.2 (CH₃). I-54

¹H NMR (401 MHz, CDCl3) δ 6.82 (d, J = 1.6 Hz, 1H), 6.60 (s, 1H), 6.48 (d, J = 1.6 Hz, 1H), 5.98 (d, J = 1.6 Hz, 1H), 5.91 (s, 1H), 5.28 (m, 1H), 4.309/4.301 (each dd, J = 11.9, 4.1, 3.2 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 3.13 (d, J = 15.1 Hz, 1H), 2.99 (d, J = 15.2 Hz, 1H), 2.90 (d, J = 10.9 Hz, 1H), 2.70 (dd, J = 15.4, 5.0 Hz, 1H), 2.64-2.49 (m, 3H), 2.58 (s, 3H), 2.45-2.26 (m, 3H), 2.30 (t, J = 7.1 Hz, 4H), 2.24 (s, 3H), 2.15-2.08 (m, 2H), 1.87 (m, 1H), 1.70-1.46 (m, 7H), 1.67 (s, 3H), 1.65 (s, 6H), 1.38 (s, 3H), 1.35-1.21 (m, 53H), 1.13 (d, J = 6.3 Hz, 3H), 1.02 (s, 3H), 0.88 (t, J = 6.9 Hz, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 171.4 (C), 171.3 (C), 169.7 (C), 154.4 (C), 149.7 (C), 149.4 (C), 142.7 (C), 138.4 (C), 136.4 (C), 134.4 (C), 133.3 (C), 132.6 (CH), 123.8 (CH), 123.2 (CH), 115.24 (C), 115.20 (CH), 113.9 (CH), 77.5 (C), 69.3 (CH), 62.2 (2C; CH₂), 47.8 (CH₂), 45.7 (CH), 41.4 (CH₂), 40.7 (CH₂), 39.4 (C), 35.5 (CH₂), 34.19 (CH), 34.15 (2C; CH₂), 32.1 (2C; CH₂), 31.9 (2C; CH₃), 31.6 (CH₂), 31.2 (CH₂), 30.6 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 27.5 (CH₃), 27.3 (CH), 25.5 (CH₃), 25.0 (3C; CH₂), 23.6 (CH₃), 22.8 (2C; CH₂), 22.7 (CH₂), 20.4 (CH₃), 19.9 (CH₃), 19.4 (CH₃), 14.3 (2C; CH₃), 14.2 (CH₃). I-55

¹H NMR (401 MHz, CDCl₃) δ 6.57 (d, J = 1.7 Hz, 1H), 6.51 (d, J = 1.7 Hz, 1H), 5.94 (m, 1H), 5.87 (dd, J = 5.7, 3.3 Hz, 1H), 5.83 (dd, J = 5.6, 4.3 Hz, 1H), 5.27 (m, 1H), 4.306/4.303 (each dd, J = 11.9, 4.2 Hz, 2H), 4.14 (dd, J = 11.9, 6.0 Hz, 2H), 3.15 (m, 1H), 2.55-2.41 (m, 5H), 2.38-2.25 (m, 6H), 2.17- 2.09 (m, 2H), 1.90 (m, 1H), 1.66 (s, 3H), 1.71-1.53 (m, 7H), 1.41 (s, 3H), 1.40-1.19 (m, 53H), 1.09 (s, 3H), 1.05 (d, J = 5.8 Hz, 3H), 0.88 (t, J = 6.9 Hz, 9H). I-56

¹H NMR (401 MHz, CDCl₃) δ 6.55 (d, J = 1.6 Hz, 1H), 6.38 (d, J = 1.7 Hz, 1H), 5.93 (m, 1H), 5.27 (m, 1H), 4.298/4.294 (each dd, J = 11.9, 4.3 Hz, 2H), 4.18-4.08 (m, 4H), 3.04 (m, 1H), 2.65-2.54 (m, 2H), 2.52- 2.36 (m, 5H), 2.33-2.19 (m, 6H), 2.17-2.10 (m, 2H), 1.93-1.71 (m, 5H), 1.65 (s, 3H), 1.70-1.49 (m, 7H), 1.40 (s, 3H), 1.40-1.19 (m, 53H), 1.08 (s, 3H), 1.03 (d, J = 6.5 Hz, 3H), 0.88 (t, J = 6.7 Hz, 9H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.3 (C), 171.5 (C), 171.1 (C), 154.6 (C), 149.4 (C), 142.9 (C), 134.9 (C), 123.5 (CH), 115.4 (CH), 115.2 (C), 114.0 (CH), 77.6 (C), 69.3 (CH), 64.0 (CH₂), 62.2 (2C; CH₂), 45.7 (CH), 40.83 (CH₂), 40.81 (CH₂), 35.6 (CH₂), 34.3 (CH), 34.2 (2C; CH₂), 34.0 (CH₂), 32.1 (2C; CH₂), 31.6 (CH₂), 31.1 (CH₂), 30.7 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.78 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.3 (CH₂), 27.6 (CH₃), 27.5 (CH), 25.1 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₃), 22.8 (2C; CH₂), 22.7 (CH₂), 21.5 (CH₂), 19.8 (CH₃), 19.5 (CH₃), 14.3 (2C; CH₃), 14.2 (CH₃).

Example 11: Synthesis of (E)-6-(4-(((4-(1,3-bis(palmitoyloxy)propan-2-yl)oxy)-4-oxobutanoyl)oxy)methoxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid (MPA-I-6)

Synthesis of MPA-I-6

Synthesis of MPA-I-6. MPA-I-6 is prepared according to the following procedure. 1.1 is prepared by treating a suitably protected mycophenolic acid (i.e., wherein P is a suitable carboxyl protecting group) with chloromethyl methyl thioether as described in WO 2009/143295, which is hereby incorporated by reference in its entirety. A solution of sulfuryl chloride (2.2 equiv.) in CH₂Cl₂ (0.16 M) is added to a solution of 1.1 (1.8 equiv.) in CH₂Cl₂ (0.07 M) at 0° C. and the mixture stirred at 0° C. for 30 minutes and then at rt for a further hour. The reaction is concentrated under a stream of N2, co-evaporated from toluene (twice) and dried under reduced pressure. The crude residue is re-dissolved in toluene (0.1 M based on 1.1), added to a solution of acid 1.2 (1 equiv.), as prepared in WO 2017/041139, and DBU (1.5 equiv.) in toluene (0.05 M) that had been pre-stirred for one hour, and the mixture is stirred at rt for two hours. The reaction is diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ (20 mL) and brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords MPA-I-6.

Example 12: Synthesis of (E)-6-(6-methoxy-7-methyl-3-oxo-4-((5,8,13-trioxo-10-((palmitoyloxy)methyl)-2,4,9,12-tetraoxaoctacosanoyl)oxy)-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid, MPA-I-7

Synthesis of MPA-I-7

Synthesis of 2.2. 2.2 is prepared according to the following procedure. Chloromethyl chloroformate (1.6 equiv.) and pyridine (3.0 equiv.) are added to a suitably protected mycophenolic acid (ie where P is a suitable carboxyl protecting group) 2.1 (1.0 equiv.) in CH₂Cl₂ (0.03 M) at 0° C. and the mixture is stirred at 0° C. for 15 minutes and then at rt for one hour. The reaction is diluted with CH₂Cl₂ and the organic phase washed with sat. aq. NaHCO₃ and brine, dried (MgSO₄) and concentrated under reduced pressure to give 2.2 which is used without purification.

Synthesis of MPA-I-7. 2.4 is prepared according to the following procedure. Silver carbonate (0.7 equiv.) is added to acid 2.3 (1.2 equiv.) as prepared in WO 2017/041139, in DMF (0.03 M) and the mixture stirred at rt for one hour. The reaction is concentrated under reduced pressure to give a grey residue, to which is added chloromethyl carbonate 2.2 (1.0 equiv.) in toluene (0.03 M) and TBAI (0.3 equiv.) and the mixture heated at reflux for 1.5 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product 2.4. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords MPA-I-7.

Example 13: Synthesis of (E)-6-(4-((3-(2-((4-((1,3-bis(palmitoyloxy)propan-2-yl)oxy)-4-oxobutanoyl)oxy)-4,6-dimethylphenyl)-3-methylbutanoyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid, MPA-I-8

Synthesis of MPA-I-8

Synthesis of MPA-I-8. MPA-I-8 is prepared according to the following procedure. DMAP (1.3 equiv.) and EDC.HCl (2.1 equiv.) is added to a solution of acid 3.1 (1.0 equiv.) as prepared in WO 2017/041139, and a suitably protected mycophenolic acid (i.e. where P is a suitable carboxyl protecting group such as an alkyl or phenyl ester) 3.2 (1.3 equiv.) in CH₂Cl₂ (0.02 M) and the mixture stirred at RT for 19 hours. The reaction is diluted with CH₂Cl₂ (10 mL), silica gel is added, and the mixture concentrated under reduced pressure and purified by silica gel chromatography. Deprotection of the ester and purification, e.g. by silica gel chromatography with a suitable solvent mixture, affords MPA-I-8.

Compound MPA-I-8′ was prepared as follows. DMAP (2.4 mg, 19.8 μmol) and EDC.HCl (9.5 mg, 49.4 μmol) were added to a solution of TML acid-TG 3.1 (19.0 mg, 21.8 μmol) and methyl ester 3.2 (6.6 mg, 19.8 μmol, P=Me) in CH₂Cl₂ (1 mL) and the mixture stirred at RT for 3.5 hours. The reaction was diluted with CH₂Cl₂ (10 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (20% to 25% ethyl acetate/hexanes) gave prodrug MPA-(O-TML-C4-2-TG)-OMe (MPA-I-8′) (22.0 mg, 94%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 6.78 (d, J=1.9 Hz, 1H), 6.58 (d, J=1.8 Hz, 1H), 5.28 (m, 1H), 5.10 (s, 2H), 4.99 (m, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.16 (dd, J=11.9, 5.8 Hz, 2H), 3.72 (s, 3H), 3.61 (s, 3H), 3.32 (s, 2H), 3.11 (d, J=5.1 Hz, 2H), 2.92 (t, J=6.7 Hz, 2H), 2.76 (t, J=6.7 Hz, 2H), 2.57 (s, 3H), 2.36-2.22 (m, 8H), 2.19 (s, 3H), 2.17 (s, 3H), 1.73 (s, 3H), 1.65 (s, 6H), 1.64-1.54 (m, 4H), 1.35-1.19 (m, 48H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.5 (2C; C), 171.5 (C), 171.4 (C), 170.0 (C), 168.4 (C), 162.8 (C), 149.6 (C), 146.3 (C), 146.0 (C), 138.2 (C), 136.3 (C), 134.2 (C), 133.5 (C), 132.6 (CH), 129.6 (C), 123.1 (CH), 122.79 (C), 122.77 (CH), 113.6 (C), 69.7 (CH), 68.4 (CH₂), 62.0 (2C; CH₂), 61.2 (CH₃), 51.6 (CH₃), 47.0 (CH₂), 38.9 (C), 34.5 (CH₂), 34.1 (2C; CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.4 (2C; CH₃), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 29.0 (CH₂), 25.5 (CH₃), 25.0 (2C; CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃); ESI-HRMS: calcd. for C₇₀H₁₀₈NaO₁₅ [M+Na⁺ ]1211.7580; found 1211.7563.

Example 14: Synthesis of (E)-6-(4-(2-((4-((4-((1,3-bis(palmitoyloxy)propan-2-yl)oxy)-4-oxobutanoyl)oxy)benzyl)oxy)-2-oxoethoxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid, MPA-I-9

Synthesis of MPA-I-9

Synthesis of MPA-I-9. MPA-I-9 is prepared according to the following procedure. DMAP (1.3 equiv.) and DIPEA (0.3 equiv.) are added to a solution of a suitably protected mycophenolic acid (i.e. where P is a suitable carboxyl protecting group), 4.1 (1.2 equiv.) and PNP carbonate 4.2 (1.0 equiv.) as prepared in WO 2017/041139, in CH₂Cl₂ (0.01 M) and the mixture stirred at rt for about five days. The reaction is diluted with CH₂Cl₂, washed with 1 M HCl, water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords MPA-I-9.

Example 15: Synthesis of (E)-6-((4-((4-((4-((1,3-bis(palmitoyloxy)propan-2-yl)oxy)-4-oxobutanoyl)oxy)butanoyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoic acid, MPA-I-10

Synthesis of MPA-I-10

Synthesis of 5.3. DMAP (1.3 equiv.) and DCC (2.1 equiv.) are added to a solution of a suitably protected mycophenolic acid (i.e., where P is a suitable carboxyl protecting group) (1.0 equiv.) and 4-bromobutyric acid 5.2 (1.3 equiv.) in CH₂Cl₂ (0.03 M) and the mixture is stirred at rt for 24 hours. Another 0.6 eq. of acid, 1 eq. of DCC, 0.6 eq. of DMAP are added and the mixture is stirred at rt for a further two days. The reaction is diluted with CH₂Cl₂, silica gel is added, and the mixture is concentrated under reduced pressure. Purification by silica gel chromatography gives bromide 5.3.

Synthesis of MPA-I-10. DBU (1.6 equiv.) is added to a suspension of acid 5.4 (1.1 equiv.) as prepared in WO 2017/041139, and bromide 5.3 (1.0 equiv.) in toluene (0.03 M) and the mixture is heated at reflux for 21 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords MPA-I-10.

Compounds MPA-I-1, MPA-I-2, MPA-I-3, MPA-I-4, MPA-I-5, MPA-I-11, MPA-I-12, MPA-I-13, MPA-I-14, and MPA-I-15 may be prepared by methods substantially similar to those described in Examples 1 through 5, the General Synthetic Schemes provided herein, and methods known to one of ordinary skill in the art.

Example 16: Synthesis of MPA-Phenol Prodrugs

Synthesis of MPA-Phenol Prodrugs (Directly-Linked) MPA Methyl Ester (Methyl (E)-6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoate) (2)

DMAP (95.3 mg, 0.280 mmol) and EDC.HCl (300 mg, 1.56 mmol) were added to a solution of mycophenolic acid (1) (250 mg, 0.780 mmol) in CH₂Cl₂ (5 mL) and MeOH (3 mL) and the mixture stirred at rt for 17 hours. The reaction was diluted with CH₂Cl₂ (20 mL), silica gel was added and the solvent removed under reduced pressure. Purification by silica gel chromatography (25% to 30% ethyl acetate/hexanes) gave methyl ester 2 (125 mg, 48%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.66 (s, 1H), 5.23 (m, 1H), 5.19 (s, 2H), 3.75 (s, 3H), 3.61 (s, 3H), 3.37 (d, J=6.8 Hz, 2H), 2.42-2.36 (m, 2H), 2.33-2.26 (m, 2H), 2.14 (s, 3H), 1.79 (s, 3H). ¹³C NMR (101 MHz, CDCl₃) δ 173.9 (C), 173.1 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.3 (C), 122.9 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 61.1 (CH₃), 51.6 (CH₃), 34.7 (CH₂), 33.0 (CH₂), 22.7 (CH₂), 16.2 (CH₃), 11.7 (CH₃).

(E)-1-(1,3-Bis(palmitoyloxy)propan-2-yl) 10-(6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl) 3-methyldecane-dioate (4d; n=4, R^(β)=Me) (MPA-I-16)

DMAP (2.4 mg, 19.6 μmol) and EDC.HCl (9.4 mg, 48.9 μmol) were added to a solution of methyl ester 2 (6.5 mg, 19.6 μmol) and acid-TG Int-30 (15.0 mg, 19.6 μmol) in CH₂Cl₂ (1.2 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (25% ethyl acetate/hexanes) gave MPA prodrug MPA-(O-C10bMe-2-TG)-OMe (4d) (MPA-I-16) (19.3 mg, 91%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 5.13 (s, 2H), 5.10 (m, 1H), 4.28 (dd, J=12.0, 3.9 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.78 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.5 Hz, 2H), 2.67 (t, J=7.5 Hz, 2H), 2.41-2.25 (m, 9H), 2.21 (s, 3H), 2.11 (dd, J=14.7, 8.6 Hz, 1H), 1.94 (m, 1H), 1.83-1.73 (m, 2H), 1.76 (s, 3H), 1.65-1.55 (m, 4H), 1.49-1.16 (m, 56H), 0.93 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.4 (2C; C), 172.5 (C), 171.8 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.4 (C), 122.9 (C), 122.5 (CH), 113.7 (C), 68.9 (CH), 68.4 (CH₂), 62.3 (2C; CH₂), 61.3 (CH₃), 51.6 (CH₃), 41.8 (CH₂), 36.8 (CH₂), 34.6 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.62 (3C; CH₂), 29.50 (2C; CH₂), 29.41 (2C; CH₂), 29.30 (CH₂), 29.26 (2C; CH₂), 26.9 (CH₂), 25.0 (2C; CH₂), 24.7 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 19.6 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃).

Further compounds were prepared in a similar manner as described below.

DMAP (11.4 mg, 0.0933 mmol) and EDC.HCl (32.1 mg, 0.167 mmol) were added to a solution of methyl ester 2 (31.0 mg, 0.0930 mmol) and acid-TG Int-28 (62.2 mg, 0.0930 μmol) in CH₂Cl₂ (4 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (20 mL), washed with water (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (15% ethyl acetate/hexanes) gave MPA prodrug MPA-(O-C4-2-TG)-OMe (MPA-I-17) (38.5 mg, 42%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 5.28 (m, 1H), 5.14 (s, 2H), 5.12 (m, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.16 (dd, J=11.9, 5.7 Hz, 2H), 3.78 (s, 3H), 3.61 (s, 3H), 3.35 (d, J=6.8 Hz, 2H), 3.03 (t, J=7.1 Hz, 2H), 2.83 (t, J=7.0 Hz, 2H), 2.41-2.35 (m, 2H), 2.33-2.27 (m, 6H), 2.22 (s, 3H), 1.79 (s, 3H), 1.64-1.55 (m, 4H), 1.37-1.17 (m, 48H), 0.87 (t, J=6.9 Hz, 6H).

DMAP, 6.0 mg, 49.1 μmol) and DCC (19.0 mg, 92.1 μmol) were added to a solution of methyl ester 2 (17.0 mg, 50.8 μmol) and acid-TG Int-29 (35.0 mg, 50.2 μmol) in CH₂Cl₂ (2 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (20% ethyl acetate/hexanes) gave MPA prodrug MPA-(O-C6-2-TG)-OMe (4b) (MPA-I-18) (25.0 mg, 49%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 5.26 (m, 1H), 5.14 (s, 2H), 5.10 (td, J=6.7, 1.1 Hz, 1H), 4.30 (dd, J=11.9, 4.4 Hz, 2H), 4.15 (dd, J=11.9, 5.8 Hz, 2H), 3.78 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.5 Hz, 2H), 2.70 (t, J=6.8 Hz, 2H), 2.44-2.25 (m, 10H), 2.22 (s, 3H), 1.89-1.73 (m, 4H), 1.77 (s, 3H), 1.65-1.55 (m, 4H), 1.33-1.20 (m, 48H), 0.88 (t, J=6.9 Hz, 6H).

DMAP (5.2 mg, 42.5 μmol) and EDC.HCl (14.1 mg, 73.5 μmol) were added to a solution of methyl ester 2 (12.0 mg, 35.8 μmol) and acid-TG Int-9 (28.0 mg, 19.6 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for 20 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (10% to 25% ethyl acetate/hexanes) gave MPA prodrug MPA-(O-C10-2-TG)-OMe (4c) (MPA-I-19) (30.5 mg, 80%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.26 (m, 1H), 5.13 (s, 2H), 5.10 (td, J=6.7, 1.1 Hz, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.77 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.6 Hz, 2H), 2.67 (t, J=7.6 Hz, 2H), 2.41-2.25 (m, 10H), 2.21 (s, 3H), 1.82-1.73 (m, 2H), 1.76 (s, 3H), 1.68-1.55 (m, 6H), 1.47-1.19 (m, 66H), 0.87 (t, J=6.8 Hz, 6H).

DMAP (2.2 mg, 17.9 μmol) and EDC.HCl (7.1 mg, 37.1 μmol) were added to a solution of methyl ester 2 (6.0 mg, 17.9 μmol) and acid-TG Int-27 (14.5 mg, 17.9 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (20% ethyl acetate/hexanes) gave MPA prodrug MPA-(O-C12a′bMe-2-TG)-OMe (4e) (MPA-I-20) (18.8 mg, 93%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 5.13 (s, 2H), 5.10 (td, J=6.5, 1.1 Hz, 1H), 4.284/4.282 (each dd, J=11.8, 4.3 Hz, 2H), 4.14 (dd, J=11.8, 6.0 Hz, 2H), 3.77 (s, 3H), 3.61 (s, 3H), 3.32 (br s, 2H), 2.79 (m, 1H), 2.40-2.34 (m, 2H), 2.33-2.26 (m, 7H), 2.21 (s, 3H), 2.11 (dd, J=14.7, 8.5 Hz, 1H), 1.98-1.85 (m, 2H), 1.76 (s, 3H), 1.65-1.54 (m, 4H), 1.36 (d, J=7.0 Hz, 3H), 1.47-1.16 (m, 61H), 0.93 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 174.6 (C), 173.7 (C), 173.4 (2C; C), 172.5 (C), 168.3 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.4 (C), 122.9 (C), 122.6 (CH), 113.8 (C), 68.9 (CH), 68.3 (CH₂), 62.3 (2C; CH₂), 61.2 (CH₃), 51.6 (CH₃), 41.8 (CH₂), 39.5 (CH), 36.9 (CH₂), 34.5 (CH₂), 34.2 (2C; CH₂), 33.4 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.74 (3C; CH₂), 29.68 (CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 27.3 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 19.6 (CH₃), 16.8 (CH₃), 16.5 (CH₃), 14.2 (2C; CH₃), 11.9 (CH₃).

(E)-15-(1,3-bis(palmitoyloxy)propan-2-yl) 1-(6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl) 2,13-dimethylpentadecanedioate (MPA-I-29)

DMAP (4.3 mg, 35.1 μmol) and EDC.HCl (11.8 mg, 61.5 μmol) were added to a solution of methyl ester 2 (10.0 mg, 29.9 μmol) and acid-TG Int-62 (27.5 mg, 32.3 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture was concentrated under reduced pressure. Purification by silica gel chromatography (25% ethyl acetate/hexanes) gave prodrug MPA-(O-C15a′bMe-2-TG)-OMe 4f (MPA-I-29) (34.3 mg, 98%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 5.14 (s, 2H), 5.10 (td, J=6.6, 1.2 Hz, 1H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (td, J=11.9, 6.0 Hz, 2H), 3.77 (s, 3H), 3.62 (s, 3H), 3.32 (br s, 2H), 2.80 (dd, J=13.9, 7.0 Hz, 1H), 2.41-2.26 (m, 9H), 2.22 (s, 3H), 2.11 (dd, J=14.7, 8.4 Hz, 1H), 1.97-1.86 (s, 2H), 1.76 (s, 3H), 1.65-1.53 (m, 6H), 1.36 (d, J=7.0 Hz, 3H), 1.47-1.15 (m, 69H), 0.92 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H).

(E)-1-(1,3-bis(palmitoyloxy)propan-2-yl) 12-(6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl) dodecanedioate (MPA-I-30)

DMAP (2.9 mg, 23.9 μmol) and EDC.HCl (11.5 mg, 59.8 μmol) were added to a solution of methyl ester 2 (8.0 mg, 23.9 μmol) and acid-TG Int-37 (22.4 mg, 28.7 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for 17 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (4% to 8% ethyl acetate/toluene) gave prodrug MPA(O-C12-2-TG)-OMe 4g (MPA-I-30) (9.1 mg, 35%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 5.26 (m, 1H), 5.14 (s, 2H), 5.10 (td, J=6.7, 1.2 Hz, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.78 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.6 Hz, 2H), 2.67 (t, J=7.6 Hz, 2H), 2.41-2.35 (m, 2H), 2.34-2.27 (m, 8H), 2.22 (s, 3H), 1.83-1.73 (m, 2H), 1.76 (s, 3H), 1.66-1.55 (m, 6H), 1.48-1.20 (m, 60H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.5 (2C; C), 173.0 (C), 171.8 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.4 (C), 122.9 (C), 122.5 (CH), 113.8 (C), 69.0 (CH), 68.4 (CH₂), 62.2 (2C; CH₂), 61.3 (CH₃), 51.6 (CH₃), 34.6 (CH₂), 34.4 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (4C; CH₂), 29.51 (2C; CH₂), 29.47 (CH₂), 29.44 (CH₂), 29.42 (2C; CH₂), 29.34 (CH₂), 29.27 (3C; CH₂), 25.1 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃).

(E)-1-(1,3-bis(palmitoyloxy)propan-2-yl) 15-(6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl) 3-methylpentadecanedioate (MPA-I-31)

DMAP (1.5 mg, 11.9 μmol) and EDC.HCl (5.7 mg, 29.9 μmol) were added to a solution of methyl ester 2 (4.0 mg, 11.9 μmol) and acid-TG Int-49 (12.0 mg, 14.3 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for five hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (5% to 8% ethyl acetate/toluene) gave prodrug MPA(O-C15bMe-2-TG)-OMe 4h (MPA-I-31) (10.8 mg, 78%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 5.27 (m, 1H), 5.14 (s, 2H), 5.10 (td, J=6.7, 1.2 Hz, 1H), 4.286/4.285 (each dd, J=11.9, 4.2 Hz, 2H), 4.141-4.139 (dd, J=11.9, 6.0 Hz, 2H), 3.78 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.5 Hz, 2H), 2.67 (t, J=7.6 Hz, 2H), 2.41-2.25 (m, 5H), 2.30 (t, J=7.6 Hz, 4H), 2.22 (s, 3H), 2.11 (dd, J=14.7, 8.4 Hz, 1H), 1.93 (m, 1H), 1.83-1.73 (m, 2H), 1.76 (s, 3H), 1.65-1.55 (m, 4H), 1.47-1.14 (m, 66H), 0.93 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.5 (2C; C), 172.5 (C), 171.8 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.4 (C), 122.9 (C), 122.5 (CH), 113.8 (C), 68.9 (CH), 68.4 (CH₂), 62.3 (2C; CH₂), 61.3 (CH₃), 51.7 (CH₃), 41.9 (CH₂), 36.9 (CH₂), 34.6 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 30.0 (CH₂), 29.85 (7C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.67 (CH₂), 29.62 (2C; CH₂), 29.51 (4C; CH₂), 29.42 (2C; CH₂), 29.36 (CH₂), 29.27 (3C; CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃).

(E)-12-(1,3-bis(palmitoyloxy)propan-2-yl) 1-(6-methoxy-7-methyl-5-(3-methyl-6-(2-morpholinoethoxy)-6-oxohex-2-en-1-yl)-3-oxo-1,3-dihydroisobenzofuran-4-yl) 2,10-dimethyldodecanedioate (MPA-I-32)

DMAP (1.7 mg, 13.6 μmol) and EDC.HCl (6.5 mg, 34.0 μmol) were added to a solution of mofetil (prepared by esterification of MPA with 2-(morpholino)ethanol; see, e.g., US 2010/0298560, hereby incorporated by reference in its entirety) (5.9 mg, 13.6 μmol) and acid-TG Int-27 (11.0 mg, 13.6 μmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (50% to 75% ethyl acetate/hexanes) gave prodrug MPA-(O-C12a′bMe-2-TG)-OMF 4i (MPA-I-32) (11.7 mg, 70%) as a colorless oil. ¹H NMR (400 MHz, CD₃OD) δ 5.31-5.24 (m, 3H), 5.07 (td, J=6.3, 1.0 Hz, 1H), 4.357/4.355 (each dd, J=11.9, 3.8 Hz, 2H), 4.21 (t, J=5.4 Hz, 2H), 4.159/4.155 (each dd, J=12.0, 6.3 Hz, 2H), 3.81 (s, 3H), 3.77-3.68 (m, 4H), 3.37 (d, J=5.0 Hz, 2H), 2.94-2.64 (m, 7H), 2.49-2.41 (m, 2H), 2.36-2.24 (m, 7H), 2.27 (s, 3H), 2.15 (dd, J=14.7, 7.7 Hz, 1H), 1.98-1.84 (m, 2H), 1.80 (s, 3H), 1.66-1.54 (m, 4H), 1.34 (d, J=7.0 Hz, 3H), 1.52-1.19 (m, 62H), 0.96 (d, J=6.7 Hz, 3H), 0.90 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CD₃OD) δ 174.8 (2C; C), 170.3 (C), 164.2 (C), 148.5 (C), 147.1 (C), 135.8 (C), 130.4 (C), 124.7 (C), 123.8 (CH), 114.5 (C), 70.6 (CH), 69.9 (CH₂), 66.9 (2C; CH₂), 63.4 (2C; CH₂), 61.9 (CH₃), 61.3 (CH₂), 57.8 (CH₂), 54.5 (2C; CH₂), 42.6 (CH₂), 40.6 (CH), 37.7 (CH₂), 35.3 (CH₂), 34.9 (CH₂), 34.7 (CH₂), 33.5 (CH₂), 33.1 (CH₂), 31.6 (CH), 30.9 (CH₂), 30.82 (6C; CH₂), 30.81 (5C; CH₂), 30.75 (3C; CH₂), 30.6 (2C; CH₂), 30.5 (2C; CH₂), 30.4 (2C; CH₂), 30.2 (2C; CH₂), 28.3 (CH₂), 28.1 (CH₂), 26.0 (2C; CH₂), 24.4 (CH₂), 23.7 (2C; CH₂), 20.2 (CH₃), 17.4 (CH₃), 16.7 (CH₃), 14.5 (2C; CH₃), 11.8 (CH₃). Note: A number of C═O signals were not observed, while a number of other signals were significantly broadened in both the ¹H and ¹³C NMR spectra. A larger amount of sample will be required to re-acquire the ¹³C NMR spectrum to observe all signals; ESI-HRMS: calcd. for C₇₂H₁₂₂NO₁₄ [M+H⁺] 1224.8860; found 1224.8866.

(E)-1-(1,3-bis(palmitoyloxy)propan-2-yl) 12-(6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl) 2,11-dimethyldodecanedioate (MPA-I-42)

To a solution of methyl ester 2 (0.2 g, 0.247 mmol) in chloroform (10 ml) were added DCC (0.101 g, 0.494 mmol) and DMAP (0.060 g, 0.494 mmol), then the reaction mixture was stirred at rt for 30 min, then Int-81 (0.165 g, 0.494 mmol) was added and stirred at rt for 18 h. The reaction was monitored by TLC. After completion of the reaction, the reaction mixture was filtered through a celite bed and washed with DCM (50 mL), then the filtrate was evaporated to obtain crude product, which was purified by combi flash purification to obtain MPA-(O-C12a′aMe-2-TG)-OMe (MPA-I-42) (0.080 g, 28.7%) as a viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 5.30 (t, J=5.3 Hz, 1H), 5.16 (s, 2H,), 5.13 (d, J=16.8 Hz, 1H), 4.31 (dd, J=11.7, 3.7 Hz, 2H), 4.17 (dd, J=11.9, 6.1 Hz, 2H), 3.79 (s, 3H), 3.64 (s, 3H), 3.34 (bs, 2H), 2.82 (q, J=6.9 Hz, 1H), 2.48-2.30 (m, 10H), 2.24 (s, 3H), 1.92 (s, 2H), 1.78 (s, 3H), 1.64-1.52 (m, 10H), 1.39-1.37 (m, 10H), 1.28 (m, 48H), 1.16 (d, J=6.8 Hz, 3H), 0.89 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 175.96 (1C), 174.55 (1C), 173.65 (1C), 173.32 (2C), 168.19 (1C), 162.63 (1C), 146.22 (1C), 146.01 (1C), 134.53 (1C), 129.32 (1C), 122.80 (1C), 122.47 (2C), 113.72 (1C), 68.69 (1C), 68.26 (1C), 62.16 (1C), 61.15 (1C), 51.55 (1C), 39.55 (1C), 39.39 (1C), 34.38 (1C), 34.07 (2C), 33.65 (1C), 33.33 (1C), 32.74 (1C), 31.96 (3C), 29.73-29.16 (23C), 27.22 (1C), 24.88 (2C), 23.53 (1C), 22.73 (2C), 17.04 (1C), 16.74 (1C), 16.39 (1C), 14.17 (3C), 11.79 (1C). HPLC (ELSD): 9.90 min, 100% purity; HPLC (uv-215 nm): 9.86 min, 99.03% purity; LCMS: 9.22 min 100% purity. MASS (ESI, +ve) m/z: 1143.05 (MH+1). ELSD Method: -PDS_HPLC_GEMINI_C4 JUPITER_GRA-1. Mobile Phase: 100% MeOH; System: Agilent Technologies 1260 Infinity with PDA Detector & ELSD Detector; Column: Phenomenex JUPITER C4, 100*4.6 mm, 5μ; Column Flow: 1.0 ml/min; Column Temp: Ambient; ELSD: SPRAY CHAMBER −50° C.

Compound MPA-(O-C10aMe-2-TG)-OMe (MPA-I-45) was prepared using similar methods as those described above.

¹H NMR (400 MHz, CDCl₃) δ 5.31 (t, J=4.8 Hz, 1H), 5.18 (s, 2H), 5.14 (m, 1H), 4.31 (dd, J=11.9, 3.9 Hz, 2H), 4.17 (dd, J=11.9, 6.1 Hz, 2H), 3.82 (s, 3H), 3.67 (s, 3H), 3.38 (d, J=6.0 Hz, 2H), 2.71 (t, J=6.8 Hz, 2H), 2.51-2.49 (m, 1H), 2.47 (m, 2H), 2.38 (dt, J=28.8, 7.3 Hz, 6H), 2.26 (s, 3H), 1.81 (s, 4H), 1.69-1.58 (m, 4H), 1.45 (s, 4H), 1.29 (s, 54H), 1.19 (d, J=7.0 Hz, 4H), 0.92 (t, J=6.7 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 175.93 (1C), 173.66 (1C), 173.33 (2C), 171.65 (1C), 168.29 (1C), 162.65 (1C), 146.18 (1C), 146.02 (1C), 134.48 (1C), 129.23 (1C), 122.84 (1C), 122.37 (2C), 113.60 (1C), 68.71 (1C), 68.34 (1C), 62.16 (2C), 61.19 (2C), 51.55 (2C), 39.53 (1C), 34.43 (1C), 34.08 (2C), 33.84 (1C), 33.58 (1C), 32.74 (1C), 31.96 (2C), 29.74-28.95 (20C), 27.16 (1C), 24.89 (2C), 24.60 (1C), 23.57 (1C), 22.73 (2C), 17.04 (1C), 16.30 (1C), 14.17 (2C), 11.82 (1C). HPLC (ELSD): 9.42 min, 100% purity; HPLC (uv-215 nm): 8.95 min, 96.05% purity; LCMS: 9.08 min 100% purity; MS (ESI, +ve) m/z: 1101.10 (MH+18). ELSD Method: —PDS_HPLC_GEMINI_C4_JUPITER_GRA-1; Mobile Phase: 100% MeOH; System: Agilent Technologies 1260 Infinity with PDA Detector & ELSD Detector; Column: Phenomenex JUPITER C4, 100*4.6 mm, 5μ; Column Flow: 1.0 ml/min; Column Temp: Ambient; ELSD: SPRAY CHAMBER −50° C.

MPA-phenol lipid prodrugs such as MPA(O-TML-C12-2-TG)-OMe (MPA-I-47), which includes a trimethyl lock SI group, were synthesized in a similar manner, i.e., by coupling of the appropriate carboxylic acid-containing prodrug group with DMAP and EDC.

MPA-I-47 was prepared by coupling methyl ester 2 to the appropriate prodrug intermediate in 80% yield using DMAP and EDC. ¹H NMR (401 MHz, CDCl₃) δ 6.77 (d, J=2.0 Hz, 1H), 6.55 (d, J=1.9 Hz, 1H), 5.26 (m, 1H), 5.10 (s, 2H), 4.98 (m, 1H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.72 (s, 3H), 3.61 (s, 3H), 3.32 (br s, 2H), 3.10 (br d, J=4.9 Hz, 2H), 2.58 (t, J=7.6 Hz, 2H), 2.57 (s, 3H), 2.36-2.20 (m, 10H), 2.19 (s, 3H), 2.17 (s, 3H), 1.79-1.71 (m, 2H), 1.73 (s, 3H), 1.65 (br s, 6H), 1.67-1.56 (m, 6H), 1.43-1.20 (m, 60H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.4 (2C; C), 173.0 (C), 172.9 (C), 170.1 (C), 168.4 (C), 162.8 (C), 149.8 (C), 146.2 (C), 146.0 (C), 138.2 (C), 136.2 (C), 134.1 (C), 133.5 (C), 132.5 (CH), 129.6 (C), 123.2 (CH), 122.82 (CH), 122.77 (C), 113.6 (C), 69.0 (CH), 68.4 (CH₂), 62.2 (2C; CH₂), 61.2 (CH₃), 51.6 (CH₃), 47.1 (CH₂), 39.0 (C), 35.2 (CH₂), 34.5 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 31.5 (2C; CH₃), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.77 (2C; CH₂), 29.62 (4C; CH₂), 29.50 (2C; CH₂), 29.48 (CH₂), 29.44 (CH₂), 29.41 (2C; CH₂), 29.38 (CH₂), 29.26 (3C; CH₂), 25.5 (CH₃), 25.03 (CH₂), 25.00 (2C; CH₂), 24.9 (CH₂), 23.5 (CH₂), 22.8 (2C; CH₂), 20.4 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃); ESI-HRMS: calcd. for C₇₈H₁₂₄NaO₁₅ [M+Na⁺] 1323.8832; found 1323.8844.

Compound MPA(O-TML-C12a′aMe-2-TG)-OMe (MPA-I-52) was prepared using similar methods as those described above and employing Int-122.

Note: The ¹H NMR spectrum of this compound suggested the presence of ca. 10% of a related MPA species that could not be removed even after a second attempt at chromatography. ¹H NMR (401 MHz, CDCl₃) δ 6.76 (d, J=1.8 Hz, 1H), 6.50 (d, J=1.6 Hz, 1H), 5.26 (m, 1H), 5.10 (s, 2H), 4.97 (m, 1H), 4.291/4.283 (each dd, J=11.8, 4.2 Hz, 2H), 4.14 (dd, J=11.9, 6.1 Hz, 2H), 3.72 (s, 3H), 3.61 (s, 3H), 3.33 (br s, 2H), 3.12 (br s, 2H), 2.69 (m, 1H), 2.57 (s, 3H), 2.43 (m, 1H), 2.36-2.27 (m, 6H), 2.25-2.14 (m, 2H), 2.19 (s, 3H), 2.17 (s, 3H), 1.84 (m, 1H), 1.72 (s, 3H), 1.70-1.51 (m, 13H), 1.46-1.19 (m, 63H), 1.13 (d, J=7.0 Hz, 3H), 0.88 (t, J=6.8 Hz, 6H).

Compound MPA(O-C11-2-TG)-OMe (MPA-I-48) was prepared using similar methods as those described above.

¹H NMR (401 MHz, CDCl₃) δ 5.25 (m, 1H), 5.13 (s, 2H), 5.10 (m, 1H), 4.28 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.77 (s, 3H), 3.61 (s, 3H), 3.32 (d, J=6.5 Hz, 2H), 2.66 (t, J=7.6 Hz, 2H), 2.40-2.24 (m, 10H), 2.21 (s, 3H), 1.81-1.72 (m, 2H), 1.76 (d, J=0.8 Hz, 3H), 1.66-1.55 (m, 6H), 1.46-1.18 (m, 58H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.4 (2C; C), 173.0 (C), 171.8 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.3 (C), 122.9 (C), 122.5 (CH), 113.7 (C), 69.0 (CH), 68.4 (CH₂), 62.2 (2C; CH₂), 61.3 (CH₃), 51.6 (CH₃), 34.5 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 32.8 (CH₂), 32.1 (2C; CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.60 (2C; CH₂), 29.49 (2C; CH₂), 29.45 (CH₂), 29.42 (CH₂), 29.40 (2C; CH₂), 29.28 (CH₂), 29.24 (2C; CH₂), 29.21 (CH₂), 25.01 (CH₂), 24.99 (2C; CH₂), 24.7 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃); ESI-HRMS: calcd. for C₆₄H107013 [M+Et] 1083.7706; found 1083.7710.

Compound MPA(O-C12bMe-2-TG)-OMe (MPA-I-53) was prepared using similar methods as those described above.

¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 5.13 (s, 2H), 5.10 (m, 1H), 4.284/4.282 (each dd, J=11.8, 4.3 Hz, 2H), 4.139/4.138 (each dd, J=11.9, 6.0 Hz, 2H), 3.77 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.5 Hz, 2H), 2.67 (t, J=7.6 Hz, 2H), 2.41-2.25 (m, 9H), 2.21 (s, 3H), 2.11 (dd, J=15.4, 9.2 Hz, 1H), 1.93 (m, 1H), 1.82-1.73 (m, 2H), 1.76 (d, J=0.8 Hz, 3H), 1.65-1.55 (m, 4H), 1.47-1.15 (m, 60H), 0.93 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.8 (C), 173.4 (2C; C), 172.5 (C), 171.8 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.2 (C), 134.6 (C), 129.4 (C), 122.9 (C), 122.5 (C), 113.7 (C), 68.9 (CH), 68.4 (CH₂), 62.3 (2C; CH₂), 61.3 (CH₃), 51.6 (CH₃), 41.8 (CH₂), 36.9 (CH₂), 34.5 (CH₂), 34.2 (2C; CH₂), 34.0 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.76 (2C; CH₂), 29.63 (CH₂), 29.61 (2C; CH₂), 29.50 (2C; CH₂), 29.47 (CH₂), 29.40 (2C; CH₂), 29.33 (CH₂), 29.25 (2C; CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 19.7 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃).

Example 17: Synthesis of MPA-Phenol Prodrugs with CASI/CMSI Group

Synthesis of MPA-Phenol Prodrugs with CASI/CMSI Group Methyl (E)-6-(4-(((chloromethoxy)carbonyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoate (5a; R═H)

Chloromethyl chloroformate (7.3 μL, 82.2 μmol) and pyridine (12.5 μL, 154 μmol) were added to methyl ester 2 (17.2 mg, 51.4 μmol) in CH₂Cl₂ (1.5 mL) at 0° C. and the mixture stirred at 0° C. for 20 minutes and then at RT for one hour. The reaction was diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ (3×20 mL) and brine (2×20 mL each), dried (MgSO₄) and concentrated under reduced pressure to give chloromethyl carbonate 5a (21.9 mg, quant.) as a colorless oil that was used without purification; ¹H NMR (401 MHz, CDCl₃) δ 5.85 (s, 2H), 5.18 (s, 2H), 5.10 (m, 1H), 3.81 (s, 3H), 3.62 (s, 3H), 3.41 (d, J=6.8 Hz, 2H), 2.41-2.36 (m, 2H), 2.32-2.26 (m, 2H), 2.25 (s, 3H), 1.78 (d, J=0.8 Hz, 3H).

Methyl (E)-6-(4-(((1-chloroethoxy)carbonyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydro-isobenzofuran-5-yl)-4-methylhex-4-enoate (5b; R=Me)

1-Chloroethyl chloroformate (5.8 μL, 53.8 μmol) and pyridine (6.5 μL, 80.7 μmol) were added to methyl ester 2 (15.0 mg, 44.9 μmol) in CH₂Cl₂ (1 mL) at 0° C. and the mixture stirred at 0° C. for five minutes and then at rt for 40 minutes. The reaction was diluted with CH₂Cl₂ (30 mL) and the organic phase washed with water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give chloroethyl carbonate 5b (19.8 mg, quant.) as a colorless oil that was used without purification. ¹H NMR (401 MHz, CDCl₃) δ 6.52 (q, J=5.8 Hz, 1H), 5.18 (s, 2H), 5.11 (td, J=6.9, 1.2 Hz, 1H), 3.80 (s, 3H), 3.62 (s, 3H), 3.46-3.34 (m, 2H), 2.41-2.35 (m, 2H), 2.32-2.25 (m, 2H), 2.24 (s, 3H), 1.94 (d, J=5.8 Hz, 3H), 1.78 (d, J=0.6 Hz, 3H).

(E)-12-(1,3-Bis(palmitoyloxy)propan-2-yl) 1-(((((6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl)oxy)carbonyl)oxy)methyl) 2,10-dimethyldodecanedioate (6a) (MPA-I-21)

Potassium carbonate (13.8 mg, 99.8 μmol) and tetra-n-butylammonium iodide (TBAI, 10.2 mg, 27.6 μmol) were added to a solution of acid-TG Int-27 (50.0 mg, 61.7 μmol) and chloride 5a (24.0 mg, 56.2 μmol) in DMF (2 mL) and the mixture heated at 80° C. for two hours. The reaction was cooled to RT, diluted with water (20 mL) and the aqueous phase extracted with ethyl acetate (3×20 mL). The combined organic extracts were washed with water (2×20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (5% to 20% ethyl acetate/hexanes) gave MPA-CASI prodrug MPA(O-CASI-C12a′bMe-2-TG)-OMe (6a) (MPA-I-21) (8.6 mg, 13%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.91 (d, J=5.6 Hz, 1H), 5.86 (d, J=5.6 Hz, 1H), 5.37 (m, 1H), 5.16 (s, 2H), 5.11 (m, 1H), 4.28 (dd, J=11.8, 4.2 Hz, 2H), 4.14 (dd, J=12.3, 5.1 Hz, 2H), 3.79 (s, 3H), 3.62 (s, 3H), 3.38 (d, J=7.1 Hz, 2H), 2.55 (m, 1H), 2.41-2.26 (m, 9H), 2.23 (s, 3H), 2.10 (dd, J=14.7, 8.5 Hz, 1H), 1.92 (m, 1H), 1.76 (s, 3H), 1.66-1.50 (m, 6H), 1.38-1.23 (m, 60H), 1.21 (d, J=7.0 Hz, 3H), 0.92 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H).

Example 18: Synthesis of MPA-Phenol Prodrugs with FSI5 Group

Synthesis of MPA-Phenol Prodrugs with FSI5 Group Methyl (E)-6-(4-((5-bromopentanoyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoate (7)

DMAP (10.9 mg, 0.0897 mmol) and EDC.HCl (43.0 mg, 0.224 mmol) were added to a solution of 5-bromovaleric acid (24.4 mg, 0.135 mmol) and methyl ester 2 (30.0 mg, 0.0897 mmol) in CH₂Cl₂ (2 mL) and the mixture stirred at RT for 30 minutes. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (35% ethyl acetate/hexanes) gave 5-bromovalerate ester 7 (38.1 mg, 85%) as a colorless solid; ¹H NMR (401 MHz, CDCl₃) δ 5.13 (s, 2H), 5.08 (m, 1H), 3.77 (s, 3H), 3.61 (s, 3H), 3.47 (t, J=6.4 Hz, 2H), 3.33 (d, J=6.6 Hz, 2H), 2.71 (t, J=7.0 Hz, 2H), 2.40-2.33 (m, 2H), 2.32-2.25 (m, 2H), 2.21 (s, 3H), 2.07-1.88 (m, 4H), 1.76 (d, J=0.7 Hz, 3H). ¹³C NMR (101 MHz, CDCl₃) δ 173.7 (C), 171.2 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.0 (C), 134.7 (C), 129.3 (C), 123.1 (C), 122.4 (CH), 113.6 (C), 68.5 (CH₂), 61.3 (CH₃), 51.6 (CH₃), 34.5 (CH₂), 33.4 (CH₂), 32.82 (CH₂), 32.81 (CH₂), 31.9 (CH₂), 23.7 (CH₂), 23.2 (CH₂), 16.4 (CH₃), 11.9 (CH₃).

(E)-12-(1,3-Bis(palmitoyloxy)propan-2-yl) 1-(5-((6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl)oxy)-5-oxopentyl) 2,10-dimethyldodecanedioate (8a) (MPA-I-22)

Silver carbonate (4.3 mg, 15.4 μmol) and tetra-n-butylammonium iodide (TBAI, 3.5 mg, 9.7 μmol) were added to a solution of acid-TG Int-27 (17.2 mg, 21.2 μmol) and bromide 7 (9.6 mg, 19.3 μmol) in toluene (1 mL) and the mixture heated at 90° C. for two hours. The reaction was cooled to RT, diluted with ethyl acetate (40 mL) and the organic phase washed with water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (20% to 25% ethyl acetate/hexanes) gave MPA-(O-FSI5-C12a′bMe-2-TG)-OMe prodrug 8a (MPA-I-22) (17.6 mg, 74%) as a colorless oil; ¹H NMR (401 MHz, CDCl₃) δ 5.27 (m, 1H), 5.14 (s, 2H), 5.10 (td, J=6.6, 1.1 Hz, 1H), 4.28 (dd, J=11.9, 3.6 Hz, 2H), 4.17-4.08 (m, 4H), 3.78 (s, 3H), 3.62 (s, 3H), 3.33 (d, J=6.7 Hz, 2H), 2.73 (t, J=6.5 Hz, 1H), 2.46-2.25 (m, 6H), 2.30 (t, J=7.6 Hz, 4H), 2.22 (s, 2H), 2.10 (dd, J=14.7, 8.4 Hz, 1H), 1.97-1.74 (m, 5H), 1.77 (d, J=0.8 Hz, 3H), 1.70-1.52 (m, 6H), 1.45-1.20 (m, 60H), 1.14 (d, J=7.0 Hz, 3H), 0.92 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 177.1 (C), 173.7 (C), 173.4 (2C; C), 172.5 (C), 171.3 (C), 168.4 (C), 162.8 (C), 146.3 (C), 146.1 (C), 134.7 (C), 129.3 (C), 123.0 (C), 122.5 (CH), 113.7 (C), 68.9 (CH), 68.5 (CH₂), 63.9 (CH₂), 62.3 (2C; CH₂), 61.3 (CH₃), 51.7 (CH₃), 41.8 (CH₂), 39.7 (CH), 36.9 (CH₂), 34.5 (CH₂), 34.2 (2C; CH₂), 33.9 (CH₂), 33.4 (CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.72 (CH₂), 29.68 (CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.2 (CH₂), 27.4 (CH₂), 27.1 (CH₂), 25.0 (2C; CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 21.3 (CH₂), 19.7 (CH₃), 17.2 (CH₃), 16.4 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃).

(E)-1-(1,3-bis(palmitoyloxy)propan-2-yl) 10-(5-((6-methoxy-5-(6-methoxy-3-methyl-6-oxohex-2-en-1-yl)-7-methyl-3-oxo-1,3-dihydroisobenzofuran-4-yl)oxy)-4-methyl-5-oxopentyl) 3-methyldecanedioate (MPA-I-33)

Synthesis of Additional MPA-Phenol Prodrugs with FSI5 Group Methyl (E)-6-(4-((5-iodo-2-methylpentanoyl)oxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoate (Int-89)

DMAP (3.4 mg, 27.5 μmol) and EDC.HCl (13.2 mg, 68.8 mmol) were added to a solution of 5-iodo-2-valeric acid (9.9 mg, 41.3 mmol) and MPA methyl ester 2 (9.2 mg, 27.5 mmol) in CH₂Cl₂ (0.8 mL) and the mixture stirred at RT for 17 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (40% ethyl acetate/hexanes) gave semi-pure ester Int-89 (13.0 mg, 85%) as a colorless solid. Note: The quoted yield is not accurate due to significant amounts of inseparable impurities in the sample, presumably carried forward from 5-iodo-2-valeric acid. As a result, the NMR spectra contained a number of additional signals—the major peaks are reported. ¹H NMR (401 MHz, CDCl₃) δ 5.14 (s, 2H), 5.09 (m, 1H), 3.77 (s, 3H), 3.62 (s, 3H), 3.35-3.22 (m, 4H), 2.83 (m, 1H), 2.40-2.33 (m, 2H), 2.32-2.25 (m, 2H), 2.22 (s, 3H), 2.03-1.93 (m, 2H), 1.77 (s, 3H), 1.67-1.58 (m, 2H), 1.39 (d, J=7.0 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 174.0 (C), 173.7 (C), 168.4 (C), 162.8 (C), 146.4 (C), 146.0 (C), 134.9 (C), 129.5 (C), 123.1 (C), 122.5 (CH), 113.8 (C), 68.4 (CH₂), 61.3 (CH₃), 51.7 (CH₃), 38.6 (CH), 34.5 (CH₂), 34.3 (CH₂), 32.9 (CH₂), 31.0 (CH₂), 23.6 (CH₂), 17.2 (CH₃), 16.6 (CH₃), 11.9 (CH₃), 6.8 (CH₂).

Silver carbonate (2.6 mg, 9.3 μmol) and tetra-n-butylammonium iodide (TBAI, 1.7 mg, 4.7 μmol) were added to a solution of acid-TG Int-30 (9.8 mg, 12.8 μmol) and iodide Int-89 (6.5 mg, 11.6 μmol) in toluene (0.8 mL) and the mixture heated at reflux for two hours. The reaction was cooled to RT, diluted with ethyl acetate (40 mL) and the organic phase washed with water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (20% to 25% ethyl acetate/hexanes) gave prodrug MPA-(O-FSI5α-C10βMe-2-TG)-OMe (MPA-I-33) (6.9 mg, 50%) as a colorless oil. ¹H NMR (401 MHz, CDCl₃) δ 5.26 (m, 1H), 5.14 (s, 2H), 5.09 (td, J=6.4, 1.0 Hz, 1H), 4.28 (dd, J=12.0, 4.1 Hz, 2H), 4.18-4.06 (m, 4H), 3.77 (s, 3H), 3.62 (s, 3H), 3.32 (br s, 2H), 2.84 (m, 1H), 2.40-2.25 (m, 11H), 2.22 (s, 3H), 2.10 (dd, J=14.7, 8.5 Hz, 1H), 2.01-1.87 (m, 2H), 1.85-1.77 (m, 2H), 1.76 (s, 3H), 1.69-1.52 (m, 7H), 1.39 (d, J=7.0 Hz, 3H), 1.35-1.14 (m, 56H), 0.92 (d, J=6.6 Hz, 3H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 174.2 (C), 174.0 (C), 173.5 (2C; C), 172.5 (C), 168.3 (C), 162.8 (C), 146.4 (C), 146.0 (C), 134.8 (C), 129.4 (C), 123.0 (C), 122.5 (CH), 113.8 (C), 69.0 (CH), 68.4 (CH₂), 64.3 (CH₂), 62.3 (2C; CH₂), 61.3 (CH₃), 51.7 (CH₃), 41.8 (CH₂), 39.2 (CH), 36.8 (CH₂), 34.5 (CH₂), 34.4 (CH₂), 34.2 (2C; CH₂), 32.9 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (3C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.34 (CH₂), 29.27 (2C; CH₂), 26.9 (CH₂), 26.4 (CH₂), 25.1 (CH₂), 25.0 (2C; CH₂), 23.6 (CH₂), 22.8 (2C; CH₂), 19.6 (CH₃), 17.1 (CH₃), 16.5 (CH₃), 14.3 (2C; CH₃), 11.9 (CH₃). Note: Two signals were not observed in the ¹³C NMR spectrum, possibly due to broadening of signals in proximity to the phenol ester functionality.

Example 19: Synthesis of MPA-phenol Prodrugs with ASI Group

Synthesis of MPA-I-41 and other MPA-phenol Prodrugs

To a solution of compound Int-123 (0.190 g, 0.250 mmol) in acetone (10 ml) was added NaI (0.093 g, 0.626 mmol) at room temperature and the mixture stirred at rt for 18 h. Then mycophenolic acid methyl ester 2 (0.084 g, 0.250 mmol) and sodium carbonate (0.066 g, 0.626 mmol) were added at rt and stirred for 18 h. Progress of the reaction was monitored by TLC/Mass analysis; TLC analysis showed one non-polar spot along with some amount of unreacted 2. Then the reaction mixture was diluted with DCM (25 mL) and filtered through celite and washed with DCM (10 ml). Then the organic layer was directly distilled out at reduced pressure; the resulting crude material was purified by combi flash purification, pure product eluted with 10% ethyl acetate/hexane to obtain pure compound MPA-(O-ASI-C12aaDiMe-2-TG)-OMe (MPA-I-41) (50 mg, 17%) as a viscous liquid. ¹H NMR (400 MHz, CDCl₃) δ 6.01 (d, J=6.4 Hz, 1H), 5.96 (d, J=6.4 Hz, 1H), 5.31 (d, J=6.3 Hz, 1H), 5.20 (s, 3H), 4.33 (dd, J=11.9, 4.3 Hz, 2H), 4.18 (dd, J=11.9, 6.0 Hz, 2H), 3.80 (s, 3H), 3.66 (s, 3H), 3.39 (d, J=6.9 Hz, 2H), 2.51-2.34 (m, 12H), 2.23 (s, 3H), 1.81 (s, 2H), 1.61 (s, 15H), 1.35-1.29 (m, 52H), 1.17 (dd, J=11.2, 7.0 Hz, 6H), 0.92 (t, J=6.7 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 175.91 (2C), 175.86 (1C), 173.78 (1C), 173.31 (2C), 169.09 (1C), 162.79 (1C), 153.07 (1C), 146.68 (1C), 13.95 (1C), 129.03 (1C), 123.05 (2C), 120.93 (1C), 111.91 (1C), 90.06 (2C), 68.67 (1C), 68.43 (1C), 62.13 (1C), 60.95 (1C), 51.50 (1C), 39.52 (1C), 39.40 (1C), 34.58 (1C), 34.05 (3C), 33.61 (1C), 33.43 (1C), 32.83 (1C), 31.94 (3C), 29.72-29-14 (17C), 27.17 (1C), 24.86 (3C), 23.77 (1C), 22.71 (3C), 17.04 (1C), 16.83 (1C), 16.16 (1C), 14.15 (4C), 11.68 (1C). HPLC (ELSD): 9.73 min, 100% purity; HPLC (uv-215 nm): 9.69 min, 97.28% purity; LCMS: 7.91 min 100% purity. MASS (ESI, +ve) m/z: 1173.10 (MH+18). ELSD Method:—PDS_HPLC_GEMINI_C4_JUPITER_GRA-1; Mobile Phase: 100% Methanol; Column: Phenomenex JUPITER C4 (100*4.6) mm, 5μ; Column Flow: 1.0 mL/min; Column Temperature: Ambient; ELSD: SPRAY CHAMBER −50° C.

Compound MPA(O-ASI-C12a′bMe-2-TG)-OMe (MPA-I-44) was prepared using similar methods.

¹H NMR (400 MHz, CDCl₃) δ 6.01-5.99 (dd, J=6.4 Hz, 2H), 5.34-5.30 (m, 1H), 5.19 (s, 3H), 4.34-4.30 (dd, J=11.9, 4.3 Hz, 2H), 4.20-4.16 (dd, J=11.9, 6.0 Hz, 2H), 3.80 (s, 3H), 3.65 (s, 3H), 3.40-3.38 (d, J=6.9 Hz, 2H), 2.48-2.40 (m, 4H), 2.38-2.29 (m, 7H), 2.22 (s, 3H), 1.96 (m, 1H), 1.81 (s, 3H), 1.65-1.62 (m, 4H), 1.38-1.24 (m, 4H), 1.29 (m, 57H), 1.15 (d, J=7.0 Hz, 4H), 0.97-0.93 (d, J=7.0 Hz, 3H), 0.91-0.90 (t, J=6.7 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) 175.87 (1C), 173.78 (1C), 173.32 (1C), 172.35 (1C), 169.09 (1C), 162.82 (1C), 153.10 (1C), 146.70 (1C), 133.97 (1C), 129.07 (1C), 123.10 (1C), 120.94 (1C), 111.94 (1C), 90.09 (1C), 68.82 (1C), 68.43 (1C), 62.16 (1C), 60.96 (1C), 51.50 (1C), 41.71 (1C), 39.43 (1C), 36.73 (1C), 34.61 (1C), 34.07 (1C), 33.45 (1C), 32.86 (1C), 31.96 (1C), 30.38 (1C), 29.80-29.15 (30C), 27.17 (1C), 26.96 (1C), 24.88 (1C), 23.80 (1C), 22.73 (1C), 19.55 (1C), 16.84 (1C), 16.18 (1C), 14.16 (1C), 11.68 (1C). HPLC (ELSD): 9.77 min, 98.71% purity; HPLC (uv-215 nm): 9.74 min, 95.42% purity; LCMS: 8.80 min 100% purity; MS (ESI, +ve) m/z: 1173.10 (MH+18). ELSD Method: -PDS_HPLC_GEMINI_C4_JUPITER_GRA-1; Mobile Phase: 100% MEOH; System: Agilent Technologies 1260 Infinity with PDA Detector & ELSD Detector. Column: Phenomenex JUPITER C4, 100*4.6 mm, 5μ; Column Flow: 1.0 ml/min; Column Temp: Ambient; ELSD: SPRAY CHAMBER −50° C.

Using similar methods to those described above, compound MPA-(O-ET-C2-2-TG)-OMe (MPA-I-23) was prepared.

Synthesis of MPA-I-23

Potassium carbonate (6.6 mg, 47.9 μmol) and tetra-n-butylammonium iodide (4.4 mg, 12.0 μmol) were added to a solution of methyl ester 2 (8.0 mg, 23.9 μmol) and bromide Int-91 (20.1 mg, 31.1 μmol) in DMF (1.5 mL) and the mixture heated at 100° C. for 30 minutes. The reaction was cooled to rt, diluted with ethyl acetate (20 mL) and the organic phase washed with water and brine (20 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave MPA prodrug MPA-I-23 (10.1 mg, 45%) as a colourless solid. ¹H NMR (401 MHz, CDCl₃) δ 5.32 (m, 1H), 5.20 (m, 1H), 5.13 (s, 2H), 5.08 (s, 2H), 4.30 (dd, J=12.0, 4.4 Hz, 2H), 4.15 (dd, J=12.0, 5.9 Hz, 2H), 3.77 (s, 3H), 3.60 (s, 3H), 3.56 (d, J=6.8 Hz, 2H), 2.41-2.34 (m, 2H), 2.32-2.26 (m, 6H), 2.17 (s, 3H), 1.78 (s, 3H), 1.68-1.54 (m, 4H), 1.35-1.19 (m, 48H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.9 (C), 173.4 (2C; C), 169.2 (C), 168.7 (C), 163.1 (C), 154.6 (C), 146.7 (C), 134.0 (C), 129.1 (C), 123.6 (CH), 120.4 (C), 111.4 (C), 71.0 (CH₂), 70.0 (CH), 68.7 (CH₂), 62.0 (2C; CH₂), 61.1 (CH₃), 51.6 (CH₃), 34.7 (CH₂), 34.1 (2C; CH₂), 33.0 (CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 24.9 (2C; CH₂), 23.9 (CH₂), 22.8 (2C; CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: Calcd. for C₅₅H₉₁O₁₂ [M+H⁺] 943.6505; found 943.6508.

Using similar methods to those described above, compound MPA-(O-ET-C5-2-TG)-OMe (MPA-I-24) was prepared.

Synthesis of MPA-I-24

DBU (4.4 μL, 29.6 μmol) was added to a suspension of methyl ester 2 (5.5 mg, 16.4 μmol) and the bromide intermediate above (13.2 mg, 18.1 μmol) in toluene (0.8 mL) and the mixture heated at reflux for two hours. The reaction was cooled to rt, then diluted with ethyl acetate (40 mL). The organic phase was washed with water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave MPA prodrug MPA-I-24 (7.0 mg, 43%) as a colorless solid.

¹H NMR (401 MHz, CDCl₃) δ 5.26 (m, 1H), 5.15 (m, 1H), 5.11 (s, 2H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.21 (t, J=6.0 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 3.76 (s, 3H), 3.61 (s, 3H), 3.40 (d, J=6.6 Hz, 2H), 2.44 (t, J=7.1 Hz, 2H), 2.41-2.26 (m, 4H), 2.31 (t, J=7.5 Hz, 4H), 2.17 (s, 3H), 1.92-1.81 (m, 4H), 1.79 (s, 3H), 1.67-1.55 (m, 4H), 1.36-1.19 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.48 (3C; C), 172.70 (C), 169.07 (C), 163.00 (C), 155.82 (C), 146.85 (C), 133.91 (C), 129.13 (C), 123.89 (CH), 120.00 (C), 112.75 (C), 74.99 (CH₂), 69.11 (CH), 68.37 (CH₂), 65.19 (CH₂), 62.20 (2C; CH₂), 61.07 (CH₃), 51.62 (CH₃), 34.68 (CH₂), 34.26 (CH₂), 34.17 (2C; CH₂), 33.92 (CH₂), 32.97 (CH₂), 32.08 (2C; CH₂), 29.85 (2C; CH₂), 29.81 (2C; CH₂), 29.77 (2C; CH₂), 29.64 (2C; CH₂), 29.51 (3C; CH₂), 29.43 (2C; CH₂), 29.27 (2C; CH₂), 25.00 (2C; CH₂), 23.65 (CH₂), 22.84 (2C; CH₂), 21.41 (CH₂), 16.39 (CH₃), 14.27 (2C; CH₃), 11.68 (CH₃); ESI-HRMS: Calcd. for C₅₈H₉₇O₁₂ [M+H⁺] 985.6975; found 985.6971.

Example 20: Synthesis of (E)-2-(4-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)butoxy)propane-1,3-diyl dipalmitate (MPA-I-25) and (E)-2-((6-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)hexyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-25 and MPA-I-26)

Synthesis of MPA-I-25

Synthesis of Int-82:

Imidazole (128 mg, 1.87 mmol) and tert-butyl(chloro)dimethylsilane (TBSCl, 141 mg, 0.937 mmol) were added to a solution of mycophenolic acid (MPA, 200 mg, 0.624 mmol) in DMF (7 mL) and the mixture stirred at rt for 22 hours. Extra portions of imidazole (65.0 mg, 0.954 mmol) and TB (80.0 mg, 0.531 mmol) were added and the mixture stirred at rt for an additional two days and 18 hours. The reaction was diluted with ethyl acetate (20 mL) and water (30 mL) and the aqueous phase extracted with ethyl acetate (3×30 mL). The combined organic extracts were washed with water and brine (80 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Purification by silica gel chromatography (10% to 35% ethyl acetate/hexanes) gave MPA(OTBS) Int-82 (164 mg, 60%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 5.19 (m, 1H), 5.06 (s, 2H), 3.73 (s, 3H), 3.38 (d, J=6.3 Hz, 2H), 2.46-2.36 (m, 2H), 2.33-2.24 (m, 2H), 2.14 (s, 3H), 1.75 (s, 3H), 1.02 (s, 9H), 0.23 (s, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 179.4 (C), 169.4 (C), 163.3 (C), 151.9 (C), 146.2 (C), 133.5 (C), 127.7 (C), 124.0 (CH), 118.1 (C), 111.8 (C), 67.8 (CH₂), 60.8 (CH₃), 34.2 (CH₂), 32.9 (CH₂), 26.2 (3C; CH₃), 23.8 (CH₂), 18.9 (C), 16.4 (CH₃), 11.5 (CH₃), −3.4 (2C; CH₃).

Synthesis of Int-83:

DMAP (5.0 mg, 40.6 μmol) and DCC (11.7 mg, 56.9 μmol) were added to a solution of acid Int-82 (17.8 mg, 40.6 μmol) and alcohol Int-78 (26.0 mg, 40.6 μmol) in CH₂Cl₂ (1.5 mL) and the mixture stirred at rt for 16 hours. To ensure complete reaction, extra portions of DMAP (4 mg) and DCC (8 mg) were added and stirring continued at rt for a further five hours. The resulting suspension was diluted with CH₂Cl₂ (15 mL), cooled to 0° C. and filtered through Celite, washing with further CH₂Cl₂ (50 mL). The organic phase was washed with 1 M HCl, water, sat. aq. NaHCO₃ and brine (60 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (12.5% to 17.5% ethyl acetate/hexanes) gave protected MPA triglyceride Int-83 (37.8 mg, 88%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃): δ 5.17 (dt, J=6.5, 3.2 Hz, 1H), 5.06 (s, 2H), 4.18 (dd, J=11.6, 4.9 Hz, 2H), 4.10 (dd, J=11.6, 5.5 Hz, 2H), 4.03 (t, J=6.4 Hz, 2H), 3.73 (s, 3H), 3.67 (m, 1H), 3.56 (t, J=6.1 Hz, 2H), 3.37 (d, J=6.3 Hz, 2H), 2.41-2.22 (m, 8H), 2.15 (s, 3H), 1.75 (s, 3H), 1.70-1.53 (m, 8H), 1.36-1.16 (m, 48H), 1.03 (s, 9H), 0.88 (t, J=6.9 Hz, 6H), 0.24 (s, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (2C; C), 173.5 (C), 169.3 (C), 163.4 (C), 151.9 (C), 146.2 (C), 133.9 (C), 127.8 (C), 123.7 (CH), 118.0 (C), 111.8 (C), 75.5 (CH), 70.0 (CH₂), 67.8 (CH₂), 64.2 (CH₂), 63.1 (2C; CH₂), 60.9 (CH₃), 34.6 (CH₂), 34.3 (2C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 26.5 (CH₂), 26.2 (CH₂), 25.5 (CH₂), 25.1 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 18.9 (C), 16.5 (CH₃), 14.3 (2C; CH₃), 11.6 (CH₃), −3.4 (CH₃).

Synthesis of MPA-I-25:

Tetrabutylammonium fluoride (TBAF, 1 M in THF, 38.1 μL, 38.1 μmol) was added to a solution of TBS ether Int-83 (26.9 mg, 38.1 μmol) in THF (1.5 mL) at 0° C. and the mixture was stirred at 0° C. for 50 minutes. The reaction was diluted with ethyl acetate, quenched with water and the aqueous phase extracted with ethyl acetate. The combined organic extracts were washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (20% ethyl acetate/hexanes) gave prodrug MPA-C4-ET-2-TG (MPA-I-25) (20.0 mg, 83%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 7.68 (s, 1H), 5.23 (dd, J=7.5, 6.4 Hz, 1H), 5.19 (s, 2H), 4.18 (dd, J=11.6, 4.9 Hz, 2H), 4.10 (dd, J=11.6, 5.5 Hz, 2H), 4.03 (t, J=6.3 Hz, 2H), 3.76 (s, 3H), 3.67 (m, 1H), 3.56 (t, J=6.0 Hz, 2H), 3.38 (d, J=6.9 Hz, 2H), 2.41-2.35 (m, 2H), 2.34-2.26 (m, 6H), 2.14 (s, 3H), 1.79 (s, 3H), 1.69-1.56 (m, 8H), 1.35-1.20 (m, 48H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (2C; C), 173.5 (C), 173.1 (C), 163.8 (C), 153.8 (C), 144.2 (C), 134.3 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 75.5 (CH), 70.2 (CH₂), 70.0 (CH₂), 64.2 (CH₂), 63.1 (2C; CH₂), 61.1 (CH₃), 34.8 (CH₂), 34.3 (2C; CH₂), 33.3 (CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 26.5 (CH₂), 25.5 (CH₂), 25.1 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: calcd. for C₅₆H₉₄NaO₁₁ [M+Na⁺] 965.6688; found 965.6697.

Using similar procedures employing Int-73 instead of Int-78, compound (E)-2-((6-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methyl hex-4-enoyl)oxy)hexyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-26) was prepared.

Synthesis of MPA-I-26

Synthesis of Int-84:

DMAP (6.4 mg, 52.1 μmol) and DCC (15.1 mg, 72.9 μmol) were added to a solution of acid Int-82 (22.7 mg, 52.1 μmol) and alcohol Int-73 (38.2 mg, 57.3 μmol) in CH₂Cl₂ (1.5 mL) and the mixture stirred at rt for 16 hours. The resulting suspension was diluted with CH₂Cl₂ (10 mL), cooled to 0° C. and filtered through Celite, washing with further CH₂Cl₂ (40 mL). The organic phase was washed with 1 M HCl, water, sat. aq. NaHCO₃ and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (10% to 15% ethyl acetate/hexanes) gave MPA triglyceride Int-84 (43.6 mg, 77% over two steps) as a colorless oil; ¹H NMR (400 MHz, CDCl₃): δ 5.18 (dd, J=6.5, 5.3 Hz, 1H), 5.06 (s, 2H), 4.18 (dd, J=11.6, 5.0 Hz, 2H), 4.11 (dd, J=11.6, 5.5 Hz, 2H), 4.00 (t, J=6.7 Hz, 2H), 3.74 (s, 3H), 3.66 (m, 1H), 3.54 (t, J=6.5 Hz, 2H), 3.38 (d, J=6.3 Hz, 2H), 2.40-2.24 (m, 8H), 2.15 (s, 3H), 1.75 (s, 3H), 1.66-1.51 (m, 8H), 1.39-1.18 (m, 52H), 1.03 (s, 9H), 0.88 (t, J=6.9 Hz, 6H), 0.23 (s, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.7 (2C; C), 173.6 (C), 169.3 (C), 163.3 (C), 151.9 (C), 146.2 (C), 133.9 (C), 127.8 (C), 123.7 (CH), 118.1 (C), 111.8 (C), 75.4 (CH), 70.6 (CH₂), 67.8 (CH₂), 64.5 (CH₂), 63.1 (2C; CH₂), 60.9 (CH₃), 34.6 (CH₂), 34.3 (2C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 30.0 (CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.7 (CH₂), 26.2 (3C; CH₃), 25.9 (CH₂), 25.8 (CH₂), 25.1 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 18.9 (C), 16.5 (CH₃), 14.3 (2C; CH₃), 11.6 (CH₃), −3.4 (2C; CH₃).

Synthesis of MPA-I-26:

Tetrabutylammonium fluoride (TBAF, 1 M in THF, 60.2 μL, 60.2 μmol) was added to a solution of TBS ether Int-84 (43.6 mg, 40.2 μmol) in THF (2.5 mL) at 0° C. and the mixture was stirred at 0° C. for one hour. The reaction was diluted with ethyl acetate (10 mL) and water (20 mL) and the aqueous phase extracted with ethyl acetate (3×20 mL). The combined organic extracts were washed with water and brine (50 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (20% ethyl acetate/hexanes) gave MPA prodrug MPA-C6-ET-2-TG (MPA-I-26) (30.8 mg, 79%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 7.67 (s, 1H), 5.24 (td, J=6.9, 1.1 Hz, 1H), 5.19 (s, 2H), 4.18 (dd, J=11.6, 5.0 Hz, 2H), 4.11 (dd, J=11.6, 5.5 Hz, 2H), 4.00 (t, J=6.7 Hz, 2H), 3.76 (s, 3H), 3.67 (m, 1H), 3.54 (t, J=6.5 Hz, 2H), 3.38 (d, J=6.9 Hz, 2H), 2.42-2.35 (m, 2H), 2.35-2.26 (m, 6H), 2.14 (s, 3H), 1.80 (s, 3H), 1.66-1.51 (m, 8H), 1.39-1.19 (m, 52H), 0.88 (t, J=6.8 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.7 (C), 173.6 (2C; C), 173.1 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.2 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 75.4 (CH), 70.6 (CH₂), 70.2 (CH₂), 64.5 (CH₂), 63.1 (2C; CH₂), 61.1 (CH₃), 34.8 (CH₂), 34.3 (CH₂), 33.3 (CH₂), 32.1 (CH₂), 30.0 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.7 (CH₂), 25.9 (CH₂), 25.8 (CH₂), 25.1 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: calcd. for C₅₈H₉₈NaO₁₁ [M+Na⁺] 993.7001; found 993.7012.

Example 21: Synthesis of (E)-2-(((3-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)propoxy)carbonyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-27)

Synthesis of MPA-I-27

3-Chloropropyl chloroformate (20.3 μL, 0.169 mmol) and N,N-diethylisopropylamine (DIPEA, 54.2 μL, 0.316 mmol) were added to 1,3-diglyceride Int-2 (60.0 mg, 0.105 mmol) and DMAP (2.6 mg, 0.0211 mmol) in CH₂Cl₂ (3 mL) at 0° C. and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (30 mL) and the organic phase washed with water, sat. aq. NaHCO₃ and brine (25 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (4% to 5.5% ethyl acetate/hexanes) gave an inseparable mixture of chloropropyl carbonates Int-85 and a regioisomer (ca. 1:1 ratio, 49.8 mg, 69%) as a colorless solid. This mixture was used in the next step without further purification. ¹H NMR (400 MHz, CDCl₃) δ 5.28 (m, 1H), 4.38-4.13 (m, 6H), 3.63 (t, J=6.3 Hz, 2H), 2.35-2.29 (m, 4H), 2.18-2.10 (m, 2H), 1.66-1.56 (m, 4H), 1.36-1.19 (m, 48H), 0.88 (t, J=6.9 Hz, 6H). Note: The ¹H NMR spectrum was acquired using a sample enriched in target carbonate Int-85.

Compound Int-86 is a known compound that may be prepared as described in WO 2016/023082, hereby incorporated by reference in its entirety.

DBU (15.1 μL, 0.101 mmol) was added to a suspension of acid Int-86 (31.2 mg, 0.0867 mmol) and chloride Int-85 and its regioisomer (49.8 mg combined, 0.0722 mmol) and the mixture heated at reflux for 30 minutes. TLC analysis at this time showed very little reaction progress, so tetra-n-butylammonium iodide (TBAI, 5.0 mg, 0.0135 mmol) was added and the mixture heated at reflux for a further 3.5 hours. The reaction was cooled to rt, then diluted with ethyl acetate and water (10 mL each). The aqueous layer was separated and acidified to pH 2 with 1 M HCl, and then extracted with ethyl acetate (3×15 mL). The combined organic extracts were washed with water, sat. aq. NaHCO₃ and brine (40 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave unreacted chlorides Int-85 and its regioisomer (ca. 3:1 ratio, 30 mg) along with protected MPA prodrug Int-87 (14.5 mg) as a colorless oil. Re-subjection of the unreacted starting materials under the same reaction conditions (acid Int-86, DBU, TBAI, reflux for four hours) gave an additional batch of product Int-87 (31.9 mg total, 30% over two steps from 1,3-diglyceride Int-2). ¹H NMR (400 MHz, CDCl₃): δ 6.09 (ddt, J=16.3, 10.4, 5.9 Hz, 1H), 5.37 (ddd, J=17.2, 3.0, 1.5 Hz, 1H), 5.23 (dd, J=10.4, 1.5 Hz, 1H), 5.13 (s, 2H), 5.06 (m, 1H), 4.78 (dt, J=5.9, 1.2 Hz, 2H), 4.33 (dd, J=12.1, 4.2 Hz, 2H), 4.20 (t, J=6.7 Hz, 2H), 4.18 (dd, J=12.3, 5.9 Hz, 2H), 4.12 (t, J=6.3 Hz, 2H), 3.76 (s, 3H), 3.41 (d, J=6.7 Hz, 2H), 2.42-2.36 (m, 2H), 2.34-2.26 (m, 6H), 2.18 (s, 3H), 2.02-1.93 (m, 2H), 1.78 (s, 3H), 1.64-1.56 (m, 4H), 1.39-1.16 (m, 48H), 0.87 (t, J=6.8 Hz, 3H); ¹³C NMR (100 MHz, CDCl₃): δ 173.4 (2C; C), 173.3 (C), 169.2 (C), 162.9 (C), 155.4 (C), 154.4 (C), 146.8 (C), 134.0 (CH), 133.8 (C), 129.3 (C), 123.8 (CH), 120.1 (C), 118.3 (CH₂), 112.8 (C), 76.2 (CH₂), 73.3 (CH), 68.4 (CH₂), 65.2 (CH₂), 62.0 (2C; CH₂), 61.1 (CH₃), 60.8 (CH₂), 34.6 (CH₂), 34.1 (2C; CH₂), 33.0 (CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.1 (CH₂), 24.9 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

Synthesis of MPA-I-27:

1,3-Dimethylbarbituric acid (DMBA; 9.1 mg, 58.2 μmol) and Pd(PPh₃)₄ (1.7 mg, 1.5 μmol) were added to allyl ether Int-87 (29.5 mg, 29.1 μmol) in CH₂Cl₂ (1.5 mL) and the mixture stirred at rt for one hour. The reaction mixture was directly applied to a short pad of silica gel and eluted with ethyl acetate (50 mL). The eluent was concentrated under reduced pressure to give the crude product. Silica gel chromatography (20% ethyl acetate/hexanes) gave prodrug MPA-C5-CN-2-TG (MPA-I-27) (22.3 mg, 79%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃): δ 7.68 (s, 1H), 5.23 (td, J=6.9, 1.2 Hz, 1H), 5.19 (s, 2H), 5.07 (tt, J=5.8, 4.3 Hz, 1H), 5.29-5.21 (m, 2H), 4.33 (dd, J=12.1, 4.2 Hz, 2H), 4.20 (t, J=6.5 Hz, 2H), 4.18 (dd, J=12.1, 5.8 Hz, 2H), 4.12 (t, J=6.3 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.43-2.35 (m, 2H), 2.35-2.26 (m, 6H), 2.14 (s, 3H), 2.01-1.94 (m, 2H), 1.79 (s, 3H), 1.63-1.56 (m, 4H), 1.34-1.19 (m, 48H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃): δ 173.4 (2C; C), 173.3 (C), 173.0 (C), 163.8 (C), 154.5 (C), 153.8 (C), 144.2 (C), 134.2 (C), 122.9 (CH), 122.2 (C), 116.9 (C), 106.5 (C), 73.3 (CH), 70.2 (CH₂), 65.2 (CH₂), 62.0 (2C; CH₂), 61.1 (CH₃), 60.7 (CH₂), 34.7 (CH₂), 34.1 (2C; CH₂), 33.1 (CH₂), 32.1 (2C; CH₂), 29.83 (6C; CH₂), 29.80 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 28.1 (CH₂), 24.9 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

Using similar methods, (E)-2-((3-(4-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)phenyl)propanoyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-28) was prepared.

Synthesis of MPA-I-28

The allyl ether Int-88 was prepared as follows. DMAP (5.5 mg, 44.6 μmol), EDC.HCl (17.1 mg, 89.3 μmol) and MPA allyl ether Int-86 (16.1 mg, 44.6 μmol) were added to a solution of phenol intermediate Int-67 (32.0 mg, 44.6 μmol) in CH₂Cl₂ (3 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave the allyl ether Int-88 (37.8 mg, 80%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.18-7.12 (m, 2H), 6.93-6.88 (m, 2H), 6.10 (ddt, J=16.3, 10.4, 5.9 Hz, 1H), 5.37 (ddd, J=17.2, 3.1, 1.5 Hz, 1H), 5.30-5.20 (m, 3H), 5.14 (s, 2H), 4.79 (dt, J=5.9, 1.3 Hz, 2H), 4.28 (dd, J=11.9, 4.4 Hz, 2H), 4.13 (dd, J=11.9, 5.9 Hz, 2H), 3.76 (s, 3H), 3.45 (d, J=6.6 Hz, 2H), 2.92 (t, J=7.8 Hz, 2H), 2.66-2.58 (m, 4H), 2.41 (t, J=7.7 Hz, 2H), 2.29 (t, J=7.6 Hz, 4H), 2.18 (s, 3H), 1.84 (s, 3H), 1.66-1.54 (m, 4H), 1.34-1.17 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 171.9 (2C; C), 169.1 (C), 162.9 (C), 155.4 (C), 149.3 (C), 146.8 (C), 137.8 (C), 133.9 (CH), 133.6 (C), 129.3 (2C; CH), 129.2 (C), 124.1 (CH), 121.7 (2C; CH), 120.1 (C), 118.3 (CH₂), 112.8 (C), 76.2 (CH₂), 69.4 (CH), 68.4 (CH₂), 62.1 (2C; CH₂), 61.1 (CH₃), 35.7 (CH₂), 34.7 (CH₂), 34.1 (2C; CH₂), 33.1 (CH₂), 32.0 (2C; CH₂), 30.3 (CH₂), 29.81 (6C; CH₂), 29.77 (4C; CH₂), 29.73 (2C; CH₂), 29.6 (2C; CH₂), 29.5. (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 25.0 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 16.5 (CH₃), 14.2 (2C; CH₃), 11.7 (CH₃).

DMBA (11.1 mg, 71.4 μmol) and Pd(PPh₃)₄ (8.2 mg, 7.1 μmol) were added to allyl ether Int-88 (37.8 mg, 35.7 μmol) in CH₂Cl₂ (2 mL) and the mixture stirred at RT for 18 hours. The reaction mixture was directly applied to a short pad of silica gel and eluted with ethyl acetate. The eluent was concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave prodrug MPA-Ph-C₃₋₂-TG MPA-I-28 (28.0 mg, 77%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.69 (s, 1H), 7.17-7.12 (m, 2H), 6.94-6.87 (m, 2H), 5.33 (td, J=6.9, 1.2 Hz, 1H), 5.25 (m, 1H), 5.20 (s, 2H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.13 (dd, J=11.9, 5.8 Hz, 2H), 3.76 (s, 3H), 3.42 (d, J=6.9 Hz, 2H), 2.92 (t, J=7.8 Hz, 2H), 2.68-2.59 (m, 4H), 2.42 (t, J=7.6 Hz, 2H), 2.29 (t, J=7.6 Hz, 4H), 2.15 (s, 3H), 1.85 (s, 3H), 1.66-1.54 (m, 4H), 1.36-1.18 (m, 48H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (2C; C), 173.0 (C), 171.99 (C), 171.96 (C), 163.8 (C), 153.8 (C), 149.3 (C), 144.2 (C), 137.8 (C), 134.0 (C), 129.3 (2C; CH), 123.2 (CH), 122.2 (C), 121.7 (2C; CH), 116.9 (C), 106.5 (C), 70.2 (CH₂), 69.4 (CH), 62.1 (2C; CH₂), 61.1 (CH₃), 35.8 (CH₂), 34.8 (CH₂), 34.2 (2C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 30.3 (CH₂), 29.83 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.0 (2C; CH₂), 22.83 (2C; CH₂), 22.76 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

Using similar methods, (E)-2-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-34) was prepared from allyl-protected MPA Int-86 and Int-2 as follows.

Synthesis of (E)-2-((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)propane-1,3-diyl dipalmitate (Int-90)

DMAP (55.0 mg, 0.450 mmol) and EDC.HCl (173 mg, 0.900 mmol) were added to a solution of Int-86 (162 mg, 0.450 mmol) and Int-2 (282 mg, 0.495 mmol) in CH₂Cl₂ (10 mL) and the mixture stirred at RT for 18 hours. The reaction was diluted with CH₂Cl₂ (20 mL), silica gel was added, and the solvent removed under reduced pressure. Silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave the desired allyl-protected product (E)-2-((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)propane-1,3-diyl dipalmitate Int-90 (356 mg, 87%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 6.10 (ddt, J=16.3, 10.4, 5.9 Hz, 1H), 5.37 (dq, J=17.2, 1.5 Hz, 1H), 5.25-5.15 (m, 3H), 5.13 (s, 2H), 4.79 (dt, J=5.9, 1.3 Hz, 2H), 4.24 (dd, J=11.9, 4.5 Hz, 2H), 4.11 (dd, J=11.9, 5.8 Hz, 2H), 3.77 (s, 3H), 3.42 (d, J=6.7 Hz, 2H), 2.43-2.37 (m, 2H), 2.33-2.25 (m, 6H), 2.18 (s, 3H), 1.79 (s, 3H), 1.63-1.51 (m, 8H), 1.35-1.21 (s, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.1 (2C; C), 172.2 (C), 168.9 (C), 162.8 (C), 155.2 (C), 146.7 (C), 133.9 (CH), 133.5 (C), 129.0 (C), 123.8 (CH), 119.9 (C), 118.0 (CH₂), 112.6 (C), 76.0 (CH₂), 69.0 (CH), 68.2 (CH₂), 61.9 (2C; CH₂), 60.9 (CH₃), 34.4 (CH₂), 34.0 (2C; CH₂), 32.9 (CH₂), 31.9 (2C; CH₂), 29.68 (6C; CH₂), 29.64 (4C; CH₂), 29.60 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 29.1 (2C; CH₂), 24.8 (2C; CH₂), 23.6 (CH₂), 22.7 (2C; CH₂), 16.2 (CH₃), 14.1 (2C; CH₃), 11.5 (CH₃).

DMBA (122 mg, 0.781 mmol) and Pd(PPh₃)₄ (67.7 mg, 0.0586 mmol) were added to allyl-protected prodrug Int-90 from the previous step (356 mg, 0.391 mmol) in CH₂Cl₂ (15 mL) and the mixture stirred at RT for 2.5 hours. The reaction mixture was directly applied to a short pad of silica gel, eluted with ethyl acetate (100 mL) and the filtrate concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% ethyl acetate/hexanes) gave a slightly impure white solid, which was recrystallized from hexanes to give prodrug MPA-2-TG (MPA-I-34) (226 mg, 66%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.68 (s, 1H), 5.26-5.20 (m, 2H), 5.20 (s, 2H), 4.24 (dd, J=11.9, 4.5 Hz, 2H), 4.12 (dd, J=11.9, 5.8 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.45-2.38 (m, 2H), 2.35-2.26 (m, 6H), 2.15 (s, 3H), 1.80 (s, 3H), 1.64-1.52 (m, 8H), 1.35-1.18 (m, 48H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 173.0 (C), 172.5 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.1 (C), 123.0 (CH), 122.2 (C), 116.9 (C), 106.6 (C), 70.2 (CH₂), 69.1 (CH), 62.1 (2C; CH₂), 61.1 (CH₃), 34.6 (CH₂), 34.2 (2C; CH₂), 33.1 (CH₂), 32.1 (2C; CH₂), 29.85 (6C; CH₂), 29.81 (4C; CH₂), 29.77 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: calcd. for C₅₂H₈₇O₁₀ [M+H] 871.6294; found 871.6328.

Using similar methods, (E)-2-(2-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)acetoxy)propane-1,3-diyl dipalmitate (MPA-I-35) was prepared from allyl-protected MPA Int-86 and Int-91 as follows.

Synthesis of (E)-2-(2-((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)acetoxy)propane-1,3-diyl dipalmitate (Int-92)

DBU (15.6 μL, 104 μmol) was added to a suspension of acid Int-86 (25.9 mg, 71.7 μmol) and bromide Int-91 (prepared as described above) (45.0 mg, 65.2 μmol) in toluene (3 mL) and the mixture heated at reflux for three hours. The reaction was cooled to RT and diluted with water (10 mL). The aqueous phase was extracted with ethyl acetate (3×15 mL) and the combined organic extracts washed with sat. aq. NaHCO₃ and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (12% to 15% ethyl acetate/hexanes) gave the allyl-protected MPA triglyceride Int-92 (45.6 mg, 72%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 6.09 (ddt, J=16.3, 10.4, 5.9 Hz, 1H), 5.37 (ddd, J=17.2, 3.1, 1.5 Hz, 1H), 5.30 (m, 1H), 5.25-5.17 (m, 2H), 5.13 (s, 2H), 4.78 (dt, J=5.9, 1.3 Hz, 2H), 4.57 (s, 2H), 4.28 (dd, J=12.1, 4.2 Hz, 2H), 4.15 (dd, J=12.0, 5.9 Hz, 2H), 3.76 (s, 3H), 3.42 (d, J=6.7 Hz, 2H), 2.52-2.45 (m, 2H), 2.37-2.27 (m, 6H), 2.17 (s, 3H), 1.79 (s, 3H), 1.63-1.55 (m, 4H), 1.37-1.17 (m, 48H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.4 (2C; C), 172.6 (C), 169.2 (C), 167.2 (C), 163.0 (C), 155.4 (C), 146.8 (C), 134.0 (CH), 133.7 (C), 129.2 (C), 123.9 (CH), 120.1 (C), 118.2 (CH₂), 112.8 (C), 76.2 (CH₂), 70.4 (CH), 68.4 (CH₂), 61.9 (CH₂), 61.1 (CH₃), 60.4 (CH₂), 34.4 (CH₂), 34.1 (2C; CH₂), 32.6 (CH₂), 32.1 (2C; CH₂), 29.82 (6C; CH₂), 29.78 (4C; CH₂), 29.74 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 24.9 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.2 (2C; CH₃), 11.7 (CH₃).

DMBA (13.4 mg, 85.6 μmol) and Pd(PPh₃)₄ (2.5 mg, 2.14 μmol) were added to allyl ether Int-92 (41.5 mg, 42.8 μmol) in CH₂Cl₂ (2.5 mL) and the mixture stirred at rt for 2.5 hours. The reaction mixture was directly applied to a short pad of silica gel, eluted with ethyl acetate (40 mL) and the filtrate concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% ethyl acetate/hexanes) gave prodrug MPA-C2-2-TG (MPA-I-35) (30.9 mg, 78%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.67 (s, 1H), 5.31 (m, 1H), 5.25 (m, 1H), 5.20 (s, 2H), 4.57 (s, 2H), 4.29 (dd, J=12.1, 4.2 Hz, 2H), 4.16 (dd, J=12.1, 6.0 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.54-2.47 (m, 2H), 2.35-2.29 (m, 6H), 2.14 (s, 3H), 1.80 (s, 3H), 1.64-1.55 (m, 4H), 1.34-1.19 (m, 48H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.42 (2C; C), 173.04 (C), 172.61 (C), 167.26 (C), 163.79 (C), 153.77 (C), 144.16 (C), 134.01 (C), 123.02 (CH), 122.20 (C), 116.84 (C), 106.51 (C), 70.41 (CH), 70.17 (CH₂), 61.86 (2C; CH₂), 61.12 (CH₃), 60.44 (CH₂), 34.46 (CH₂), 34.08 (2C; CH₂), 32.64 (CH₂), 32.06 (2C; CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.60 (2C; CH₂), 29.50 (2C; CH₂), 29.39 (2C; CH₂), 29.24 (2C; CH₂), 24.93 (2C; CH₂), 22.82 (2C; CH₂), 22.72 (CH₂), 16.27 (CH₃), 14.26 (2C; CH₃), 11.69 (CH₃).

Using similar methods, (E)-2-((7-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)heptanoyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-36) was prepared from allyl-protected MPA Int-86 and Int-95 as follows.

Synthesis of (E)-2-((7-((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)heptanoyl)oxy)propane-1,3-diyl dipalmitate (Int-96)

DBU (13.6 μL, 90.7 μmol) was added to a suspension of acid Int-86 (26.2 mg, 72.6 μmol) and iodide Int-95 (48.8 mg, 60.5 μmol) and the mixture heated at reflux for 3.5 hours. The reaction was cooled to RT, then diluted with ethyl acetate and water and the aqueous layer extracted with ethyl acetate. The combined organic extracts were washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (7.5% to 15% to 20% ethyl acetate/hexanes) gave protected MPA prodrug Int-96 (47.5 mg, 76%) as a colorless oil. ¹H NMR (400 MHz, CDCl₃) δ 6.09 (ddt, J=17.1, 10.4, 5.9 Hz, 1H), 5.37 (dq, J=17.2, 1.5 Hz, 1H), 5.28-5.21 (m, 2H), 5.17 (m, 1H), 5.12 (s, 2H), 4.78 (dt, J=5.9, 1.3 Hz, 2H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.13 (dd, J=11.9, 5.9 Hz, 2H), 4.00 (t, J=6.7 Hz, 2H), 3.76 (s, 3H), 3.41 (d, J=6.7 Hz, 2H), 2.40-2.34 (m, 2H), 2.33-2.25 (m, 8H), 2.17 (s, 3H), 1.78 (s, 3H), 1.66-1.54 (m, 8H), 1.36-1.18 (m, 52H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃) δ 173.5 (C), 173.4 (2C; C), 172.8 (C), 169.2 (C), 163.0 (C), 155.4 (C), 146.8 (C), 133.99 (CH), 133.97 (C), 129.3 (C), 123.7 (CH), 120.1 (C), 118.2 (CH), 112.8 (C), 76.2 (CH₂), 69.1 (CH), 68.4 (CH₂), 64.4 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.7 (CH₂), 34.17 (2C; CH₂), 34.16 (CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.3 (2C; CH₂), 28.8 (CH₂), 28.6 (CH₂), 25.8 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

DMBA (10.8 mg, 69.3 mol) and Pd(PPh₃)₄ (2.0 mg, 1.7 μmol) were added to allyl ether Int-96 (36.0 mg, 34.6 mol) in CH₂Cl₂ (2 mL) and the mixture stirred at RT for one hour. The reaction mixture was directly applied to a short pad of silica gel and eluted with ethyl acetate (50 mL). The eluent was concentrated under reduced pressure to give the crude product. Silica gel chromatography (5% ethyl acetate/toluene) gave MPA prodrug MPA-C7-2-TG MPA-I-36 (30.6 mg, 88%) as a colorless solid. ¹H NMR (400 MHz, CDCl₃) δ 7.67 (s, 1H), 5.28-5.22 (m, 2H), 5.19 (s, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 4.00 (t, J=6.7 Hz, 2H), 3.75 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.40-2.35 (m, 2H), 2.34-2.25 (m, 8H), 2.14 (s, 3H), 1.80 (s, 3H), 1.66-1.52 (m, 8H), 1.37-1.19 (m, 52H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (100 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.1 (C), 172.8 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.3 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 69.1 (CH), 64.4 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.8 (CH₂), 34.2 (3C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 29.83 (6C; CH₂), 29.79 (4C; CH₂), 29.75 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (2C; CH₂), 29.2 (2C; CH₂), 28.8 (CH₂), 28.6 (CH₂), 25.8 (CH₂), 25.0 (2C; CH₂), 24.8 (CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: calcd. for C₅₉H98Na₀₁₂ [M+Na⁺] 1021.6951; found 1021.6946.

Using similar methods, (E)-2-((12-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)dodecanoyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-37) was prepared from allyl-protected MPA Int-86 and Int-97 as follows.

Synthesis of (E)-2-(((12-(((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)dodecanoyl)oxy)propane-1,3-diyl dipalmitate (Int-98)

DBU (27.4 μL, 0.183 mmol) was added to a suspension of Int-86 (43.3 mg, 0.120 mmol) and bromide Int-97 (95.0 mg, 0.114 mmol) in toluene (4 mL) and the mixture heated at reflux for two hours. The reaction was cooled to rt, then diluted with ethyl acetate (40 mL). The organic phase was washed with water and brine (30 mL each), dried (MgSO₄) and concentrated under reduced pressure to give the crude product. Silica gel chromatography (10% to 20% ethyl acetate/hexanes) gave Int-98 (88.2 mg, 69%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 6.07 (ddt, J=16.3, 10.4, 5.9 Hz, 1H), 5.35 (dq, J=17.2, 1.5 Hz, 1H), 5.28-5.13 (m, 3H), 5.10 (s, 2H), 4.76 (dt, J=5.9, 1.2 Hz, 2H), 4.27 (dd, J=11.9, 4.3 Hz, 2H), 4.12 (dd, J=11.9, 5.9 Hz, 2H), 3.98 (t, J=6.8 Hz, 2H), 3.74 (s, 3H), 3.39 (d, J=6.7 Hz, 2H), 2.39-2.23 (m, 10H), 2.16 (s, 3H), 1.76 (s, 3H), 1.63-1.51 (m, 8H), 1.35-1.13 (m, 62H), 0.85 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (C), 173.4 (2C; C), 172.9 (C), 169.1 (C), 162.9 (C), 155.4 (C), 146.7 (C), 133.94 (CH), 133.92 (C), 129.3 (C), 123.6 (CH), 120.0 (C), 118.1 (CH₂), 112.7 (C), 76.1 (CH₂), 69.0 (CH), 68.4 (CH₂), 64.6 (CH₂), 62.2 (2C; CH₂), 61.0 (CH₃), 34.7 (CH₂), 34.3 (CH₂), 34.1 (2C; CH₂), 33.1 (CH₂), 32.0 (2C; CH₂), 29.78 (6C; CH₂), 29.74 (4C; CH₂), 29.70 (2C; CH₂), 29.63 (CH₂), 29.60 (CH₂), 29.55 (3C; CH₂), 29.44 (2C; CH₂), 29.35 (4C; CH₂), 29.19 (2C; CH₂), 29.15 (CH₂), 28.7 (CH₂), 26.0 (CH₂), 24.9 (2C; CH₂), 23.7 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.2 (2C; CH₃), 11.6 (CH₃).

DMBA (24.2 mg, 0.155 mmol) and Pd(PPh₃)₄ (13.4 mg, 0.0116 mmol) were added to allyl ether Int-98 (86.0 mg, 0.0775 mmol) in CH₂Cl₂ (3 mL) and the mixture stirred at rt for 4.5 hours. The reaction mixture was directly applied to a short pad of silica gel and eluted with ethyl acetate. The eluent was concentrated under reduced pressure to give the crude product. Silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave prodrug MPA-I-37 (80.0 mg, 96%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.66 (s, 1H), 5.27-5.19 (m, 2H), 5.17 (s, 2H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.13 (dd, J=11.8, 5.9 Hz, 2H), 3.98 (t, J=6.8 Hz, 2H), 3.74 (s, 3H), 3.36 (d, J=6.9 Hz, 2H), 2.40-2.33 (m, 2H), 2.32-2.24 (m, 8H), 2.13 (s, 3H), 1.78 (s, 3H), 1.64-1.50 (m, 8H), 1.37-1.18 (m, 62H), 0.86 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.5 (C), 173.4 (2C; C), 173.0 (C), 172.9 (C), 163.8 (C), 153.7 (C), 144.1 (C), 134.3 (C), 122.7 (CH), 122.2 (C), 116.8 (C), 106.4 (C), 70.1 (CH₂), 69.0 (CH), 64.5 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.7 (CH₂), 34.3 (CH₂), 34.1 (2C; CH₂), 33.2 (CH₂), 32.0 (2C; CH₂), 29.79 (6C; CH₂), 29.75 (4C; CH₂), 29.71 (2C; CH₂), 29.63 (CH₂), 29.61 (CH₂), 29.56 (2C; CH₂), 29.45 (2C; CH₂), 29.36 (4C; CH₂), 29.20 (2C; CH₂), 29.16 (CH₂), 28.7 (CH₂), 26.0 (CH₂), 24.97 (CH₂), 24.95 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.2 (CH₃), 14.2 (2C; CH₃), 11.6 (CH₃).

Using similar methods, (E)-2-((18-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)octadecanoyl)oxy)propane-1,3-diyl dipalmitate (MPA-I-38) was prepared from allyl-protected MPA Int-86 and Int-105 as follows.

Synthesis of (E)-2-((18-((6-(4-(allyloxy)-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)octadecanoyl)oxy)propane-1,3-diyl dipalmitate (Int-128)

DMAP (4.6 mg, 37.4 μmol), EDC.HCl (17.9 mg, 93.4 μmol) and Int-86 (18.8 mg, 52.3 μmol) were added to a solution of alcohol Int-105 (31.8 mg, 37.4 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at RT for 19 hours. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added and the mixture concentrated under reduced pressure. Purification by silica gel chromatography (12.5% to 17.5% ethyl acetate/hexanes) gave allyl-protected prodrug Int-128 (40.6 mg, 91%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 6.10 (ddt, J=17.1, 10.4, 5.9 Hz, 1H), 5.37 (ddd, J=17.2, 3.1, 1.5 Hz, 1H), 5.30-5.21 (m, 2H), 5.17 (td, J=6.7, 1.1 Hz, 1H), 5.13 (s, 2H), 4.78 (dt, J=5.9, 1.3 Hz, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.0 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.76 (s, 3H), 3.41 (d, J=6.7 Hz, 2H), 2.39-2.25 (m, 10H), 2.18 (s, 3H), 1.78 (s, 3H), 1.66-1.52 (m, 8H), 1.37-1.18 (m, 74H), 0.88 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.0 (C), 169.1 (C), 163.0 (C), 155.4 (C), 146.8 (C), 134.00 (C), 133.97 (CH), 129.3 (C), 123.7 (CH), 120.1 (C), 118.2 (CH₂), 112.8 (C), 76.2 (CH₂), 69.0 (CH), 68.4 (CH₂), 64.6 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.7 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 33.2 (CH₂), 32.1 (2C; CH₂), 29.83 (10C; CH₂), 29.79 (6C; CH₂), 29.75 (3C; CH₂), 29.68 (CH₂), 29.65 (CH₂), 29.60 (2C; CH₂), 29.49 (2C; CH₂), 29.44 (CH₂), 29.40 (3C; CH₂), 29.24 (2C; CH₂), 29.22 (CH₂), 28.7 (CH₂), 26.0 (CH₂), 25.03 (CH₂), 24.99 (2C; CH₂), 23.8 (CH₂), 22.8 (2C; CH₂), 16.4 (CH₃), 14.2 (2C; CH₃), 11.7 (CH₃).

DMBA (10.6 mg, 68.0 mol) and Pd(PPh₃)₄ (7.8 mg, 6.8 mol) were added to allyl ether Int-128 (40.6 mg, 34.0 mol) in CH₂Cl₂ (1.5 mL) and the mixture stirred at RT for 4 h. The reaction was diluted with (10 mL), silica gel was added, and the mixture concentrated under reduced pressure. Silica gel chromatography (15% to 20% ethyl acetate/hexanes) gave MPA prodrug MPA-I-38 (38.3 mg, 98%) as a colorless solid. ¹H NMR (401 MHz, CDCl₃) δ 7.67 (s, 1H), 5.29-5.21 (m, 2H), 5.20 (s, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 4.00 (t, J=6.7 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.7 Hz, 2H), 2.42-2.35 (m, 2H), 2.35-2.26 (m, 8H), 2.14 (s, 3H), 1.80 (s, 3H), 1.67-1.51 (m, 8H), 1.45-1.15 (m, 74H), 0.88 (t, J=6.7 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.0 (2C; C), 163.8 (C), 153.8 (C), 144.1 (C), 134.4 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 69.0 (CH), 64.6 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.8 (CH₂), 34.4 (CH₂), 34.2 (2C; CH₂), 33.3 (CH₂), 32.1 (2C; CH₂), 29.83 (10C; CH₂), 29.79 (6C; CH₂), 29.75 (3C; CH₂), 29.68 (CH₂), 29.65 (CH₂), 29.61 (2C; CH₂), 29.49 (2C; CH₂), 29.44 (CH₂), 29.40 (3C; CH₂), 29.25 (2C; CH₂), 29.22 (CH₂), 28.7 (CH₂), 26.1 (CH₂), 25.04 (CH₂), 24.99 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.2 (2C; CH₃), 11.7 (CH₃).

Using similar methods, (E)-2-((4-((6-(4-hydroxy-6-methoxy-7-methyl-3-oxo-1,3-dihydroisobenzofuran-5-yl)-4-methylhex-4-enoyl)oxy)-3-methylbutanoyl)oxy)propane-1,3-diyl dibutyrate (MPA-I-43) was prepared from Int-86 and Int-125 via the allyl-protected intermediate Int-127:

Int-127: ¹H NMR (401 MHz, CDCl₃) δ 6.09 (ddt, J=17.1, 10.4, 5.9 Hz, 1H), 5.37 (dq, J=17.2, 1.5 Hz, 1H), 5.28 (m, 1H), 5.23 (m, 1H), 5.18 (m, 1H), 5.13 (s, 2H), 4.78 (dt, J=5.9, 1.3 Hz, 2H), 4.296/4.293 (each dd, J=11.9, 4.3 Hz, 2H), 4.150/4.148 (each dd, J=11.9, 6.0 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.76 (s, 3H), 3.41 (d, J=6.7 Hz, 2H), 2.39-2.25 (m, 9H), 2.17 (s, 3H), 2.12 (dd, J=14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.78 (d, J=0.7 Hz, 3H), 1.68-1.52 (m, 8H), 1.35-1.17 (m, 18H), 0.94 (t, J=7.4 Hz, 6H), 0.93 (d, J=6.7 Hz, 3H).

MPA-I-43:

MPA-I-43 was prepared from the corresponding allyl-protected compound in 58% yield after Pd-mediated deprotection. ¹H NMR (401 MHz, CDCl₃) δ 7.67 (s, 1H), 5.31-5.21 (m, 2H), 5.19 (s, 2H), 4.295/4.292 (each dd, J=11.9, 4.2 Hz, 2H), 4.149/4.197 (each dd, J=11.9, 6.0 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.41-2.26 (m, 9H), 2.14 (s, 3H), 2.12 (dd, J=14.7, 8.3 Hz, 1H), 1.93 (m, 1H), 1.79 (s, 3H), 1.69-1.52 (m, 8H), 1.36-1.15 (m, 18H), 0.94 (t, J=7.4, 2.8 Hz, 6H), 0.92 (d, J=6.7 Hz, 3H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.3 (2C; C), 173.1 (C), 172.5 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.4 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 68.9 (CH), 64.6 (CH₂), 62.3 (2C; CH₂), 61.1 (CH₃), 41.9 (CH₂), 36.8 (CH₂), 36.1 (2C; CH₂), 34.8 (CH₂), 33.3 (CH₂), 30.5 (CH), 29.9 (CH₂), 29.81 (CH₂), 29.79 (2C; CH₂), 29.74 (CH₂), 29.68 (CH₂), 29.4 (CH₂), 28.8 (CH₂), 27.1 (CH₂), 26.1 (CH₂), 22.7 (CH₂), 19.7 (CH₃), 18.5 (2C; CH₂), 16.3 (CH₃), 13.8 (2C; CH₃), 11.7 (CH₃).

Using similar methods, MPA-C10-2-TG (MPA-I-46) was prepared.

¹H NMR (401 MHz, CDCl₃) δ 7.67 (s, 1H), 5.29-5.21 (m, 2H), 5.19 (s, 2H), 4.29 (dd, J=11.9, 4.4 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.76 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.41-2.35 (m, 2H), 2.33-2.24 (m, 8H), 2.14 (s, 3H), 1.80 (s, 3H), 1.66-1.52 (m, 8H), 1.37-1.17 (m, 58H), 0.87 (t, J=6.8 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.1 (C), 173.0 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.4 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 69.0 (CH), 64.6 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 34.8 (CH₂), 34.3 (CH₂), 34.2 (2C; CH₂), 33.3 (CH₂), 32.1 (2C; CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.62 (2C; CH₂), 29.50 (3C; CH₂), 29.41 (2C; CH₂), 29.36 (2C; CH₂), 29.26 (2C; CH₂), 29.19 (CH₂), 28.8 (CH₂), 26.1 (CH₂), 25.0 (3C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

Using similar methods to those described above, MPA-C12-2-TG-butyrate (MPA-I-49) was prepared using Int-126.

¹H NMR (401 MHz, CDCl₃) δ 7.66 (s, 1H), 5.29-5.19 (m, 2H), 5.18 (s, 2H), 4.29 (dd, J=11.9, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 6.0 Hz, 2H), 3.99 (t, J=6.8 Hz, 2H), 3.75 (s, 3H), 3.37 (d, J=7.0 Hz, 2H), 2.41-2.34 (m, 2H), 2.33-2.24 (m, 8H), 2.13 (s, 3H), 1.78 (s, 3H), 1.69-1.51 (m, 8H), 1.35-1.19 (m, 14H), 0.93 (t, J=7.4 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.2 (2C; C), 173.0 (2C; C), 163.8 (C), 153.8 (C), 144.1 (C), 134.3 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 69.0 (CH), 64.6 (CH₂), 62.2 (2C; CH₂), 61.1 (CH₃), 36.0 (2C; CH₂), 34.8 (CH₂), 34.3 (CH₂), 33.2 (CH₂), 29.63 (CH₂), 29.61 (CH₂), 29.5 (CH₂), 29.4 (2C; CH₂), 29.2 (CH₂), 28.7 (CH₂), 26.0 (CH₂), 25.0 (CH₂), 22.7 (CH₂), 18.5 (2C; CH₂), 16.3 (CH₃), 13.7 (2C; CH₃), 11.7 (CH₃).

Using similar methods to those described above, MPA-C10bMe-2-TG (MPA-I-50) was prepared using Int-23.

¹H NMR (401 MHz, CDCl₃) δ 7.67 (s, 1H), 5.30-5.20 (m, 2H), 5.19 (s, 2H), 4.28 (dd, J=11.9, 4.3 Hz, 2H), 4.13 (dd, J=13.1, 4.8 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.75 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.41-2.35 (m, 2H), 2.34-2.26 (m, 7H), 2.14 (s, J=6.2 Hz, 3H), 2.11 (dd, J=14.7, 8.4 Hz, 1H), 1.90 (m, 1H), 1.79 (s, 3H), 1.67-1.52 (m, 6H), 1.36-1.14 (m, 58H), 0.92 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.1 (C), 172.4 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.4 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 69.0 (CH), 64.6 (CH₂), 62.3 (2C; CH₂), 61.1 (CH₃), 41.8 (CH₂), 36.8 (CH₂), 34.8 (CH₂), 34.2 (2C; CH₂), 33.3 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.83 (7C; CH₂), 29.79 (4C; CH₂), 29.76 (2C; CH₂), 29.6 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (3C; CH₂), 29.3 (2C; CH₂), 28.7 (CH₂), 27.0 (CH₂), 26.1 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 19.7 (CH₃), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃); ESI-HRMS: calcd. for C₆₃H₁₀₆NaO₁₂ [M+Na⁺] 1077.7576; found 1077.7576.

Using similar methods to those described above, MPA-C12bMe-2-TG (MPA-I-51) was prepared using Int-121.

¹H NMR (401 MHz, CDCl₃) δ 7.67 (s, 1H), 5.30-5.21 (m, 2H), 5.19 (s, 2H), 4.285/4.283 (each dd, J=11.8, 4.3 Hz, 2H), 4.14 (dd, J=11.9, 5.9 Hz, 2H), 4.00 (t, J=6.8 Hz, 2H), 3.75 (s, 3H), 3.38 (d, J=6.9 Hz, 2H), 2.41-2.26 (m, 9H), 2.14 (s, 3H), 2.09 (dd, J=14.8, 8.3 Hz, 1H), 1.93 (m, 1H), 1.79 (d, J=0.7 Hz, 3H), 1.64-1.52 (m, 6H), 1.41-1.15 (m, 62H), 0.92 (d, J=6.6 Hz, 3H), 0.87 (t, J=6.9 Hz, 6H); ¹³C NMR (101 MHz, CDCl₃) δ 173.6 (C), 173.4 (2C; C), 173.1 (C), 172.5 (C), 163.8 (C), 153.8 (C), 144.1 (C), 134.4 (C), 122.8 (CH), 122.3 (C), 116.8 (C), 106.5 (C), 70.2 (CH₂), 68.9 (CH), 64.6 (CH₂), 62.3 (2C; CH₂), 61.1 (CH₃), 41.8 (CH₂), 36.8 (CH₂), 34.8 (CH₂), 34.2 (2C; CH₂), 33.3 (CH₂), 32.1 (2C; CH₂), 30.5 (CH), 29.9 (CH₂), 29.84 (6C; CH₂), 29.80 (4C; CH₂), 29.76 (2C; CH₂), 29.74 (CH₂), 29.68 (CH₂), 29.62 (2C; CH₂), 29.5 (2C; CH₂), 29.4 (3C; CH₂), 29.3 (2C; CH₂), 28.8 (CH₂), 27.1 (CH₂), 26.1 (CH₂), 25.0 (2C; CH₂), 22.8 (2C; CH₂), 22.7 (CH₂), 19.7 (CH₃), 16.3 (CH₃), 14.3 (2C; CH₃), 11.7 (CH₃).

Example 22: Synthesis of TAC-I-1

Synthesis of TAC-I-1:

Synthesis of 1.1: 1.1, is prepared by treating a macrolide with chloromethyl methyl thioether as described in WO 2009/143295, which is hereby incorporated by reference in its entirety. A solution of sulfuryl chloride (2.2 equiv.) in CH₂Cl₂ (0.16 M) is added to a solution of 1.1 (1.8 equiv.) in CH₂Cl₂ (0.07 M) at 0° C. and the mixture stirred at 0° C. for 30 minutes and then at rt for an additional hour. The reaction is concentrated under a stream of N2, co-evaporated from toluene (twice) and dried under reduced pressure.

Synthesis of TAC-I-1 (TAC-32-(ASI-C4-2-TG)): TAC-I-1 is prepared according to the following procedure. The crude residue is re-dissolved in toluene (0.1 M based on 1.1), added to a solution of acid Int-28 (1 eq) as prepared in WO 2017/041139, and DBU (1.5 eq) in toluene (0.05 M) that had been pre-stirred for one hour, and the mixture is stirred at rt for two hours. The reaction is diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ (20 mL) and brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude protected product. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-1. In the instance protecting groups are not utilized, regioisomers are separated by known purification techniques to afford TAC-I-1 and TAC-I-3.

Example 23: Synthesis of TAC-I-4

Synthesis of TAC-I-4:

Synthesis of 3.2: 3.2 is prepared according to the following procedure. PG indicates an optional hydroxyl protecting group. Chloromethyl chloroformate (1.6 equiv.) and pyridine (3.0 equiv.) are added to macrolide 3.1 (1.0 equiv.) in CH₂Cl₂ (0.03 M) at 0° C. and the mixture is stirred at 0° C. for 15 minutes and then at rt for one hour. The reaction is diluted with CH₂Cl₂ and the organic phase washed with sat. aq. NaHCO₃ and brine, dried (MgSO₄) and concentrated under reduced pressure to give 3.2 which is used without purification.

Synthesis of TAC-I-4 (TAC-32-(CASI-C4-2-TG)): TAC-I-4 is prepared according to the following procedure. Silver carbonate (0.7 equiv.) is added to acid Int-28 (1.2 equiv.) as prepared in WO 2017/041139, in DMF (0.03 M) and the mixture stirred at rt for one hour. The reaction is concentrated under reduced pressure to give a grey residue, to which is added chloromethyl carbonate (1.0 equiv.) in toluene (0.03 M) and TBAI (0.3 equiv.) and the mixture heated at reflux for 1.5 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude 3.3. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-4. In the instance protecting groups are not utilized, regioisomers are separated via known purification techniques.

Example 24: Synthesis of TAC-I-7 and TAC-I-9

Synthesis of TAC-I-7 and TAC-I-9:

Synthesis of TAC-I-7 (TAC-32-(TML-C4-2-TG): TAC-I-7 is prepared according to the following procedure. 4-(Dimethylamino)pyridine (DMAP, 1.3 equiv.) and EDC.HCl (2.1 equiv.) is added to a solution of macrolide 4.1 (1.3 equiv.) and acid 4.2 (1.0 equiv.), as prepared in WO 2017/041139, in CH₂Cl₂ (0.02 M) and the mixture stirred at rt for 19 hours. The reaction is diluted with CH₂Cl₂ (10 mL), silica gel is added and the mixture concentrated under reduced pressure to yield crude. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-7. In the instance protecting groups are not utilized, regioisomers are separated via known purification techniques.

Example 25: Synthesis of TAC-I-10

Synthesis of TAC-I-10:

Synthesis of TAC-I-10. TAC-I-10 is prepared according to the following procedure. PG indicates an optional hydroxyl protecting group. 4-(Dimethylamino)pyridine (DMAP, 1.3 equiv.) and DIPEA (0.3 equiv.) were added to a solution of protected macrolide 5.1 (1.2 equiv.) and PNP carbonate 5.2 (1.0 equiv.) as prepared in WO 2017/041139, in CH₂Cl₂ (0.01 M) and the mixture stirred at rt for five days. The reaction was diluted with CH₂Cl₂, washed with 1 M HCl, water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude product 5.3. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-10. In the instance protecting groups are not utilized, regioisomers are separated by known purification techniques.

Example 26: Synthesis of TAC-I-13

Synthesis of TAC-I-13:

Synthesis of 6.3: 6.3 is prepared according to the following procedure. PG indicates an optional hydroxyl protecting group. 4-(Dimethylamino)pyridine (1.3 equiv.) and DCC (2.1 equiv.) are added to a solution of macrolide 6.1 (1.0 equiv.) and 4-bromobutyric acid 6.2 (1.3 equiv.) in CH₂Cl₂ (0.03 M) and the mixture is stirred at rt for 24 hours. Another 0.6 eq. of acid, 1 eq. of DCC, 0.6 eq. of DMAP are added and the mixture is stirred at rt for an additional two days. The reaction is diluted with CH₂Cl₂, silica gel is added and the mixture is concentrated under reduced pressure. Purification by silica gel chromatography gives bromide mixture 6.3.

Synthesis of TAC-I-13 (TAC-32-(FSI-4-C4-2-TG)): TAC-I-13 is prepared according to the following procedure. 1,8-Diazabicyclo[5.4.0]undec-7-ene (DBU) (1.6 equiv.) is added to a suspension of acid Int-28 (1.1 equiv.) as prepared in WO 2017/041139, and bromide 6.3 (1.0 equiv.) in toluene (0.03 M) and the mixture is heated at reflux for 21 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude 6.4. Deprotection and purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-13. In the instance protecting groups are not utilized, regioisomers are separated via known purification techniques.

Example 27: Synthesis of TAC-I-16

Synthesis of TAC-I-16:

Synthesis of 7.2: 7.2 is prepared according to the following procedure. PG indicates an optional hydroxyl protecting group. Chloromethyl chloroformate (1.6 equiv.) and pyridine (3.0 equiv.) are added to macrolide 7.1 (1.0 equiv.) in CH₂Cl₂ (0.03 M) at 0° C. and the mixture is stirred at 0° C. for 15 minutes and then at rt for one hour. The reaction is diluted with CH₂Cl₂ and the organic phase washed with sat. aq. NaHCO₃ and brine, dried (MgSO₄) and concentrated under reduced pressure to give 7.2 which is used without purification.

Synthesis of TAC-I-16: TAC-I-16 is prepared according to the following procedure. Silver carbonate (0.7 equiv.) is added to acid 7.3 (1.2 equiv.) as prepared in WO 2017/041139, in DMF (0.03 M) and the mixture stirred at rt for one hour. The reaction is concentrated under reduced pressure to give a grey residue, to which is added chloromethyl carbonate 7.2 (1.0 equiv.) in toluene (0.03 M) and TBAI (0.3 equiv.) and the mixture heated at reflux for 1.5 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude TAC-I-16. Purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-16. Regioisomers are separated via known purification techniques.

Example 28: Synthesis of TAC-I-17

Synthesis of TAC-I-17:

Synthesis of 8.2: 8.2 is prepared according to the following procedure. 4-(Dimethylamino)pyridine (1.3 equiv.) and DCC (2.1 equiv.) are added to a solution of macrolide 8.1 (1.0 equiv.) and 5-bromopentanoic acid (1.3 equiv.) in CH₂Cl₂ (0.03 M) and the mixture is stirred at rt for 24 hours. Another 0.6 eq. of acid, 1 eq. of DCC, 0.6 eq. of DMAP are added and the mixture is stirred at rt for an additional two days. The reaction is diluted with CH₂Cl₂, silica gel is added and the mixture is concentrated under reduced pressure. Purification by silica gel chromatography gives bromide 8.2.

Synthesis of TAC-I-17: TAC-I-17 is prepared according to the following procedure. Silver carbonate (0.7 equiv.) is added to acid 8.3 (1.2 equiv.) as prepared in WO 2017/041139, in DMF (0.03 M) and the mixture stirred at rt for one hour. The reaction is concentrated under reduced pressure to give a grey residue, to which is added bromide 8.2 (1.0 equiv.) in toluene (0.03 M) and the mixture is heated at reflux for 21 hours. The reaction is cooled to rt, then diluted with ethyl acetate. The organic phase is washed with water and brine, dried (MgSO₄) and concentrated under reduced pressure to give the crude TAC-I-17. Purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-17. Regioisomers may be separated via known purification techniques. TAC-I-18, TAC-I-19, TAC-I-20, TAC-I-21, TAC-I-22, and TAC-I-23:

Example 29: Synthesis of TAC-I-18 and TAC-I-19

Synthesis of TAC-I-18 (TAC-32 (C10-2-TG)) and TAC-I-19 (TAC-24-(C10-2-TG)): 4-(Dimethylamino)pyridine (DMAP, 2.7 mg, 21.9 μmol) and EDC.HCl (12.6 mg, 65.7 μmol) were added to a solution of tacrolimus hydrate (18.0 mg, 21.9 μmol) and acid-TG (Int-9; 18.1 mg, 24.1 μmol) in CH₂Cl₂ mL) and the mixture stirred at rt for seven days. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was added, and the solvent was removed under reduced pressure. Purification by silica gel chromatography (30% to 100% ethyl acetate/hexanes) gave TAC prodrugs TAC-I-18 (9.2 mg, 27%) and TAC-I-19 (8.0 mg, 24%) as colourless oils.

TAC-I-18:

ESI-HRMS: Calcd. for C₈₉H₁₅₁NNaO₁₉ [M+Na⁺] 1561.0773; found 1561.0745

R_(f) (50% EtOAc/Hexanes): 0.68. TAC-I-19:

ESI-HRMS: Calcd. for C₈₉H₁₅₁NNaO₁₉ [M+Na⁺] 1561.0773; found 1561.0774

R_(f) (50% EtOAc/Hexanes): 0.41. Example 30: Synthesis of TAC-I-20 and TAC-I-21

Synthesis of TAC-I-20 (TAC-32-(C12α′MeβMe-2TG)) and TAC-I-21 (TAC-24-(C12α′MeβMe-2TG)): 4-(Dimethylamino)pyridine (DMAP, 1.9 mg, 15.5 μmol) and EDC.HCl (6.0 mg, 31.1 μmol) were added to a solution of tacrolimus (12.5 mg, 15.5 μmol) and acid-TG (Int-27; 15.1 mg, 18.7 μmol) in CH₂Cl₂ (1 mL) and the mixture stirred at rt for seven days. The reaction was diluted with CH₂Cl₂ (5 mL), silica gel was then added and the solvent was removed under reduced pressure. Purification by silica gel chromatography (30% to 100% ethyl acetate/hexanes) gave TAC prodrugs TAC-I-20 (7.3 mg, 29%) and TAC-I-21 (2.3 mg, 9%) as colourless oils.

TAC-I-20:

ESI-HRMS: Calcd. for C₈₉H₁₅₁NNaO₁₉ [M+Na⁺] 1617.1399; found 1617.1357

R_(f) (50% EtOAc/Hexanes): 0.73. TAC-I-21:

ESI-HRMS: Calcd. for C₈₉H₁₅₁NNaO₁₉ [M+Na⁺] 1617.1399; found 1617.1361

R_(f) (50% EtOAc/Hexanes): 0.38. Example 31: Synthesis of TAC-I-22 and TAC-I-23

Synthesis of TAC-I-22 (TAC-24-C5βMe-2-TG) and TAC-I-23 (TAC-24-C5βMe-2-TG): 4-(Dimethylamino)pyridine (DMAP, 2.1 mg, 17.0 μmol) and EDC.HCl (6.5 mg, 34.1 μmol) were added to a solution of tacrolimus hydrate (14.0 mg, 17.0 μmol) and acid-TG 2 (Int-4; 14.2 mg, 20.4 μmol) in CH₂Cl₂ (1 mL) and the mixture was stirred at rt for five days. The reaction was diluted with CH₂Cl₂ (5 mL), then silica gel was added and the solvent was removed under reduced pressure. Purification by silica gel chromatography (25% to 60%) EtOAc/hexanes) gave TAC-I-22 (4.3 mg, 17%) and TAC-I-23 (8.6 mg, 34%) as colorless oils.

TAC-I-22: R_(f) (50% EtOAc/Hexane): 0.31. TAC-I-23: R_(f) (50% EtOAc/Hexane): 0.65. Example 32: Synthesis of TAC-I-24 and TAC-I-25

Synthesis of TAC-I-24 and TAC-I-25.

Synthesis of TAC-I-24 (TAC-32-(TML-CβMe-2-TG)) and TAC-I-25 (TAC-24-(TML-CβMe-2-TG)). TAC-I-24 and TAC-I-25 are prepared according to the following procedure. DMAP (1.3 equiv.) and EDC.HCl (2.1 equiv.) is added to a solution of acid 12.1 (1.0 equiv.) as prepared in WO 2017/041139 with Int-4, and tacrolimus 12.2 (1.3 equiv.) in CH₂Cl₂ (0.02 M) and the mixture stirred at RT for 19 hours. The reaction is diluted with CH₂Cl₂ (10 mL), silica gel is added, and the mixture concentrated under reduced pressure and purified by silica gel chromatography to affords TAC-I-24 and TAC-I-25. Optionally, hydroxyl protecting groups are utilized to enhance regioselectivity, yielding the target compounds after deprotection and purification.

Example 33: Synthesis of TAC-I-26 and TAC-I-27

Synthesis of TAC-I-26 and TAC-I-27.

Synthesis of 13.2: 13.2 is prepared by treating a macrolide 13.1 with chloromethyl methyl thioether as described in WO 2009/143295, which is hereby incorporated by reference in its entirety. A solution of sulfuryl chloride (2.2 equiv.) in CH₂Cl₂ (0.16 M) is added to a solution of 13.1 (1.8 equiv.) in CH₂Cl₂ (0.07 M) at 0° C. and the mixture stirred at 0° C. for 30 minutes and then at rt for an additional hour. The reaction is concentrated under a stream of N2, co-evaporated from toluene (twice) and dried under reduced pressure.

Synthesis of TAC-I-26 (TAC-32-(ASI-C5βMe-2-TG)) and TAC-I-27 (TAC-24-(ASI-C5βMe-2-TG)): TAC-I-26 and TAC-I-27 are prepared according to the following procedure. The crude residue of 13.2 is re-dissolved in toluene (0.1 M based on 13.1), added to a solution of acid Int-4 (1 eq) as prepared in WO 2017/041139, and DBU (1.5 eq) in toluene (0.05 M) that had been pre-stirred for one hour, and the mixture is stirred at rt for two hours. The reaction is diluted with CH₂Cl₂ (20 mL) and the organic phase washed with sat. aq. NaHCO₃ (20 mL) and brine (20 mL), dried (MgSO₄) and concentrated under reduced pressure to give the crude products. Purification by silica gel chromatography with a suitable solvent mixture affords TAC-I-26 and TAC-I-27.

Example 34: Synthesis of TAC-I-28 and TAC-I-29

Synthesis of TAC-I-28 (TAC-32-(MASI-C5βMe-2-TG)) and TAC-I-29 (TAC-32-(MASI-C5βMe-2-TG)): 4-(Dimethylamino)pyridine (DMAP, 2.7 mg, 21.9 μmol) and EDC.HCl (12.6 mg, 65.7 μmol) are added to a solution of tacrolimus hydrate (18.0 mg, 21.9 μmol) and acid-TG (Int-4; 18.1 mg, 24.1 μmol) in CH₂Cl₂ (2 mL) and the mixture is stirred at rt for seven days. The reaction is diluted with CH₂Cl₂ (5 mL), silica gel is added, and the solvent is removed under reduced pressure. Purification by silica gel chromatography with suitable solvents gives TAC prodrugs TAC-I-28 and TAC-I-29.

Example 35: Lymphatic Transport Assay in Rats

In order to assess the lymphatic transport of disclosed lipid prodrugs in rats, the mesenteric lymph ducts of the rats used in this study were cannulated to allow continual collection of mesenteric lymph. Lipid formulations containing the compound of interest were then administered to the animals, lymph was collected, and drug concentrations in the lymph samples were quantified.

Lipid-based formulations of the compounds of the invention or control compounds were prepared as previously described (Trevaskis, N. L. et al., Pharmaceutical Research, 2005, 22(11), 1863-1870, WO 2016/023082, and WO 2017/041139, hereby incorporated by reference.

In brief, either 1 or 2 mg of test prodrug, 40 mg oleic acid and 25 mg Tween 80 were mixed in a glass vial and incubated at 37° C. for 12-18 h to equilibrate. An aqueous phase consisting of 5.6 ml phosphate buffered saline (PBS, pH 7.4) was subsequently added to the lipid phase (MPA was dissolved in PBS for the preparation of MPA containing formulations) and the formulation emulsified by ultrasonication with a Misonix XL 2020 ultrasonic processor (Misonix, Farmingdale, N.Y., USA) equipped with a 3.2-mm microprobe tip running at 30% of the maximal amplitude of 240 μm and a frequency of 20 kHz for 2 min at room temperature. Doses for administering to more than one animal can be prepared in one batch by suitably increasing the quantities given above. Drug/prodrug concentrations in all formulations were verified using HPLC-MS.

Male Sprague-Dawley (SD) rats were selected for the lymphatic transport studies involving mycophenolic acid lipid prodrugs. Depending on the therapeutic agent, male, female, or both may be selected for study. Rats (typically 240-320 g) were maintained on a standard diet and fasted overnight with free access to water prior to experiments.

Anesthetized rats were placed on a heated pad at 37° C. and cannulas inserted into the duodenum (for formulation administration and rehydration), mesenteric lymph duct (for lymph collection), and carotid artery (in cases where blood collection was conducted). Post-surgery, rats were re-hydrated for 0.5 h via intraduodenal infusion of normal saline at 2.8 mL/h. The lipid formulations were infused into the duodenum at 2.8 mL/h for 2 h after which, normal saline was infused at 2.8 mL/h for the remainder of the experiment. Lymph was continuously collected for up to 8 h into pre-weighed Eppendorf tubes containing 10 μL of 1,000 IU/mL heparin. The collection tubes were changed hourly and lymph flow was measured gravimetrically. Aliquots of hourly lymph samples were stored at −20° C. prior to assay.

Drug concentration in lymph is expressed as total drug and includes free drug and drug associated with different glycerides. Lymph samples are first treated with a lipase or other appropriate conditions to liberate free active agent prior to measurement of active agent levels in the lymph. Treatment with a lipase or other hydrolysis conditions liberates free active agent from any corresponding re-esterified glycerides. Porcine pancreatic lipase is appropriate for this purpose. Alternatively, hydrolysis with 0.5 M NaOH may be used. For MPA “phenol” prodrugs (i.e. prodrugs linked to the triglyceride at the aromatic —OH group of MPA), hydrolysis was performed with 0.5 M NaOH except for the lymph samples collected from 3 rats in the group of compound MPA-I-20 (MPA-O-C12α′βMe-TG), which were hydrolyzed by porcine pancreatic lipase.

Transport of compounds into lymph during each hourly collection period was calculated from the product of the volume of lymph collected and the measured concentrations in lymph. For fluorescently-labelled compounds such as a BDP-conjugate, the concentrations of total compound may be measured by fluorescence spectroscopy without hydrolysis.

The results of the lymphatic transport assays are summarized in Table B, below, and e.g. in the attached Figures. Table B summarizes lymphatic transport of total MPA related compound (% of administered dose) following intraduodenal infusion to anaesthetised, mesenteric lymph-duct cannulated rats. Data are presented as mean±SD when n≥3 or mean±range when n=2. Compounds with a lymphatic transport assay result of greater than 10% (>10%) are designated as “A.” Compounds with a lymphatic transport assay result between 1% and 10% (1%-10%) are designated as “B.” Compounds with a lymphatic transport assay result of less than 1% and greater than 0.24% (<1% and >0.24%) are designated as “C.”

Importantly, the cumulative lymphatic transport percentages of MPA and MMF measured in this assay are very low (0.17±0.12% for MPA and even less for MMF; see FIG. 8). Accordingly, a lymphatic transport assay result of “A” means that the lipid prodrug increases cumulative lymphatic transport relative to MPA or MMF by a factor of >59. A result of “B” indicates an increase by a factor of between 5.9 and 59. A result of “C” indicates an increase by a factor of between about 1.4 and <5.9.

TABLE B Lymphatic transport of total compounds related to parent therapeutic agent (% of administered dose) following intraduodenal infusion to anesthetised, mesenteric lymph-duct cannulated rats (data are presented as mean ± SD when n ≥3 or as mean ± range when n = 2). Cumu- lative lym- phatic transport % dose (Mean ± SD, or Compound Range if Name # Structure n = 2) MPA (n = 5) —

0.17 ± 0.12 MMF — 0.14 ± (n = 3) 0.08 MPA- TG (n = 5) MPA- I-34

A MPA- Ph-C3- TG MPA- I-28

B MPA- C4(ether)- TG (n = 3) MPA- I-25

C MPA-C5- Carbonate- TG (n = 4) MPA- I-27

B MPA- C6(ether)- TG (n = 4) MPA- I-26

C MPA-C7- TG (n = 2) MPA- I-36

B MPA- C12-TG (n = 2) (dose 1 mg/rat) MPA- I-37

A MPA- C18-TG (n = 3) (dose 1 mg/rat) MPA- I-38

B MPA- O-C4- TG(OMe) (n = 2) MPA- I-17

C MPA- O-C6- TG(OMe) (n = 2) MPA- I-18

B MPA- O-C10- TG(OMe) (n = 3) MPA- I-19

A MPA- O-C12- TG(OMe) (n = 3) MPA- I-30

A MPA-O- C12α′MeβMe- TG(OMe) (n = 5) MPA- I-20

A MPA-O- CASI- C12α′MeβMe- TG(OMe) (n = 3) MPA- I-21

B MPA-O- C12α′βMe- TG (OMF) (n = 3) MPA- I-32

A MPA-O- FSI(5)- C12α′MeβMe- TG(OMe) (n = 5) MPA- I-22

A MPA-2-PL (n = 4) MPA- I-39

C MPA-O-TML- MPA- B C12-TG (n = 3) I-47 MPA-O-ASI- MPA- A C12α′βMe-TG I-44 (n = 3) MPA-O-C15β- TG (n = 2) MPA- I-31

A MPA-C10-TG (n = 3) MPA- I-46

A MPA(O-C11-2- TG)-OMe MPA- I-48

A MPA-C10β-TG (n = 3) MPA- I-50

A

The half-life of monoglyceride (MG) intermediates in rat bile and pancreatic fluid was determined for selected compounds. The data are presented in Table 3 below. The designation “A” indicates that the half-life of the MG intermediate was between 15 and 90 minutes. “B” indicates a half-life between >90 minutes and 300 minutes. “C” indicates a half-life between >300 minutes and 600 minutes. “D” indicates a half-life between >600 and 1200 minutes.

The percentage of MPA released at 60 minutes in LPL-supplemented rat plasma was also determined for selected compounds. As shown in Table C below, the designation “*” indicates a release % of 1 to 25%. The designation “**” indicates a release % of >25% to 50%. The designation “***” indicates a release % of >50% to 75%. The designation “****” indicates a release % of >75%.

TABLE C Stability of the Monoglyceride (MG) Intermediates of Lipid Prodrugs in Rat Plasma, Bile, and Pancreatic Fluid. Percentage Half-life of MPA MG release at intermediates 60 min in in rat bile LPL and supple- pancreatic mented rat fluid (min) plasma (n = 3 (n = 3 unless unless Compound specified specified Name # otherwise) otherwise) MPA-TG MPA- C *** (n = 5) I-34 MPA- MPA- C C4(ether)- I-25 TG (n = 3) MPA-C5- MPA- A Carbonate- I-27 TG (n = 4) MPA- MPA- B C6(ether)- I-26 TG (n = 4) MPA-C7- MPA- A TG (n = 2) I-36 MPA-O-C10- MPA- **** TG(OMe) I-19 (n = 3) MPA-O- MPA- *** C12α′Meβ I-20 TG(OMe) (n = 3) MPA-O- MPA- *** FSI(5)- I-22 C12α′Meβ Me- TG(OMe) (n = 2) MPA-2-PL MPA- D (n = 4) I-39

DESCRIPTION OF THE DRAWINGS

FIG. 1: Lymphatic transport of mycophenolic acid prodrug MPA-I-17 in rats following the procedure described above. Rat 1 (●); rat 2 (▪).

FIG. 2: Lymphatic transport of mycophenolic acid prodrug MPA-I-18 in rats following the procedure described above. Rat 1 (●); rat 2 (▪).

FIG. 3: Lymphatic transport of mycophenolic acid prodrug MPA-I-19 in rats following the procedure described above. Rat 1 (●); rat 2 (▪); rat 3 (▴).

FIG. 4: Lymphatic transport of mycophenolic acid prodrug MPA-I-20 in rats following the procedure described above. Rat 1 (●); rat 2 (▾); rat 3 (▪); rat 4 (∘); rat 5 (⋄).

FIG. 5: Lymphatic transport of mycophenolic acid prodrug MPA-I-21 in rats following the procedure described above. Rat 1 (●); rat 2 (▾); rat 3 (▪).

FIG. 6: lymphatic transport of phenol-conjugated MPA prodrugs (mean±SD when n≥3 or as mean±range when n=2).

FIG. 7: lymphatic transport of mycophenolic acid (MPA) and mycophenolate mofetil (MMF) (mean±SD).

TABLE D Pharmacokinetic and Lymph Data for Testosterone Lipid Prodrugs Rat- cumu- lative lympha- Plasma tic Plasma PK Rat- trans- PK measure- cumu- port: measure- Plasma ments: Plasma lative Mean, Plasma ments: Plasma PK Fold PK lym- lympha- PK Mean PK measure- increase measure- pha- tic measure- Plasma measure- ments: relative ments: tic trans- Cmd ments: AUC (0- ments: Cmax to Compa- transport: port over Name Repeat 24 hr) Tmax nmol/ Compa- rator Repeat 6 or 8 and # number (nmol.h/L (h) L) rator drug Number hours (%) TST-FSI5- 5 504.6 1.2 293.3 74 TU 2 11.3 C12abMe- (testoster- 2-TG (I- one 50) undeca- noate) TST-FSI5-05bMe- 4 583.3 0.9 822.1 85.5 TU 2-TG (I-49) TST- 3 591 0.92 638 86.6 TU 3 11.4 CMSI- C10bMe- 2-TG (I- 46) TST- 4 631.6 0.9 595.8 92.6 TU CMSI-C5bMe- 2-TG (1-44) TST- 3 268.1 0.8 358.1 39.3 TU 3 2.8 CASI-C5bMe- 2-TG (1-42) TST-ASI- 3 255.4 1.1 190.8 37.4 TU 4 8.3 C15a'bMe -2-TG (I- 41) TST-ASI-C12a'bMe 3 901 1.08 968 132.1 TU 3 27.2 -2-TG ((I- 40) TST-ASI-C10b'Me- 4 588.7 1.8 311 86.3 TU 2-TG (I-39) TST-ASI-05-2-TG 4 236 1.2 95.6 34.6 TU 3 2.3 (I-38) TST-C10-ET-2-TG 3 6.9 (I-37) TST-C10-AM-2-TG 3 1.8 (I-36) TST-C15a'bMe- 3 47.7 1.5 86.8 7 TU 2 14.2 2-TG (I- 35) TST-C12a'bMe 2 187.9 1.9 24.9 27.5 TU -2-TG (I- 34) TST-C10b'Me- 3 39.6 1.5 28 5.8 TU 2-TG (I-33) TST-C4-2- 4 18.9 1.1 13.2 2.8 TU 4 13.5 TG (1-32)

TABLE E Pharmacokinetic and Lymph Data for Additional Lipid Prodrugs Rat-cumulative Rat- lymphatic cumulative Rat- transport: lymphatic cumulative Mean, transport: lymphatic lymphatic SD, lymphatic transport: transport transport Cmpd Repeat over 6 or 8 over 6 or 8 Name and # Number hours (%) hours (%) THC-CASI- 3 66.9 18 C5bMe-2- TG (I-55) THC-TML- 3 3.4 0.9 C5bMe-2- TG (I-54) THC-C10-2- 2 82.2 1.1 TG (I-53) CBD-FSI5- 2 29.1 14 C5bMe-2- TG (I-56) CBD-C5bMe-2- 3 26.1 6.6 TG (I-20) BUP-TML- 3 44.7 19 C5bMe-2- TG (I-15) BUP-C10-2- 5 59.8 17 TG (I-14) BUP-C5bMe-2- 2 45.6 14 TG (I-13) BUP-C4-2- 3 12.9 4.1 TG (I-12)

Example 36: Prodrug Lymph Node Studies in Mice

This experiment included a single and multiple dose study. In the multiple dose study, dosing of either free MPA or MPA-2-TG (MPA-I-34, structure below) 2 times daily was performed for 2 days followed by collecting samples from mesenteric or peripheral lymph nodes on the 3^(rd) day after dosing.

The concentrations of free MPA were measured for both groups of mice.

Much higher concentrations in mesenteric lymph nodes after MPA-TG administration were observed compared with MPA. In contrast, the peripheral lymph nodes showed similar concentrations following administration of MPA-TG and MPA. The results of the multi-dose study are shown in FIGS. 8A and 8B.

As shown in FIG. 9, conversion of MPA-I-20 into its monoglyceride form (in which both palmitic acid groups are cleaved) and release of MPA from the monoglyceride could be followed over time in rat plasma supplemented with LPL. FIG. 10 shows conversion over time after administration of MPA-I-22. For both MPA-I-20 and MPA-I-22, about 80% of the MPA was released after 180 min and the monoglyceride (MG) peak had almost completely disappeared.

In FIG. 10, the “Acid” intermediate is believed to have the following structure:

“FSI(5)-OH” refers to the following intermediate structure:

Example 37: Pharmacokinetic (PK) Studies in Rats and Dogs

In order to assess the oral bioavailability of test compounds, pharmacokinetic studies were conducted using the following procedure. The day before drug administration, male Sprague-Dawley rats (240-320 g) were anesthetised and the carotid artery cannulated. The rats were then allowed to regain consciousness and fasted overnight prior to the commencement of experiments with free access to water. The next morning, formulations containing parent compounds or prodrugs were administered via oral gavage and blood samples collected from the carotid artery cannula from −5 min up to 24 h post dosing and centrifuged at 5000 rpm for 5 min to separate plasma. During the blood sample collection period, the rats had free access to water but remained fasted for a further 8 h following drug administration. Plasma samples were stored at −80° C. prior to assay by HPLC-MS-MS. Samples were assayed for free drug (i.e. non-glyceride associated drug) to determine hydrolysis (if any) prior to assay.

For the dog studies, beagle dogs will be held in a large-animal research facility prior to the commencement of studies. The dogs will be fasted for 12 h up to 30 min prior to drug administration. For the fed state studies, dogs will receive ˜20 g of high fat dog food (containing ˜34% fat), administered by hand, followed by 10 mL water to aid in swallowing, followed by 100 g standard canned dog food (˜2.5% fat) 30 min prior to drug administration. Water will be available ad libitum throughout the study for all dogs. Test compounds may be prepared in a suitable formulation such as a long-chain lipid based self-emulsifying drug delivery system (SEDDS) consisting of 30.5% w/w soybean oil, 30.5% w/w Maisine-CC, 31.6% w/w Cremophor EL and 7.4% w/w ethanol. Formulations may be filled into hard gelatin capsules. Compound dissolved in the formulation may be administrated to the fed dog by placing the capsules as far posterior to the pharynx as possible, closing the mouth and rubbing the throat to stimulate swallowing. Subsequently 50 mL of water will be administered orally via a syringe. After oral administration, blood samples (approx. 1.5 mL each) will be taken via venepuncture of the cephalic vein 5 min prior to administration up to 120 hours post-dosing. Plasma will be separated by centrifugation and aliquots of each plasma sample transferred into eppendorf tubes and stored at −80° C. prior to analysis.

For comparison purposes and to allow calculation of bioavailability, the parent drug may be administered intravenously by either infusion (over 5 min) or bolus injection of a suitable dose of drug dissolved in appropriate aqueous formulation (dependent on the nature of the parent drug (for example, for MPA, 95:5 PBS/ethanol may be used, while for other drugs, a 20% hydroxypropyl-β-cyclodextrin solution may be used). The dose also depends on nature of the parent drug. For MPA, about ˜2-3 mg per beagle is used, while for others, a higher or lower dose per beagle is used. After IV administration, blood samples (approx. 1.5 mL each) will be taken via venepuncture of the cephalic vein 5 min prior to administration up to 120 hours post-dosing. Plasma will be separated by centrifugation and aliquots of each plasma sample transferred into eppendorf tubes and stored at −80° C. prior to analysis.

Example 38: In Vitro Hydrolysis of Compounds by Rat Digestive Fluid or Porcine Pancreatic Lipase

In vitro hydrolysis of test compounds may be performed via incubation with rat digestive fluid. Rat digestive fluid will be collected from anesthetized rats via cannulation of the common bile-pancreatic duct immediately prior to the entry of the duct into the duodenum (i.e. below the point of entry of pancreatic secretions). This allows simultaneous collection of bile and pancreatic fluid. The digestive fluid will be collected continuously for 2 h, during which time a blank lipid formulation (prepared as described in the rat lymphatic transport studies but without the addition of drug) will be infused into the duodenum at a rate of 2.8 mL/h to mimic conditions following drug administration. Bile and pancreatic fluid will be maintained at 37° C. and used within 0.5 h of collection for in vitro prodrug hydrolysis experiments. The hydrolysis experiments will be conducted via incubation (at 37° C.) of ˜0.375 mL of rat digestive fluid with 0.625 ml of the drug-loaded lipid formulations (as described in the rat lymphatic transport studies). The volume ratio of digestive fluid to formulation will mimic the flow rate of bile and pancreatic fluid (−1.5 mL/h) and the infusion rate of the intraduodenal formulations (2.8 mL/h) during the in vivo lymphatic transport studies. Aliquots of 10 μL (samples taken at 0, 2, 5, 10, 15, 30, 60, 90, 120, 180 min) will be added to 990 μL of acetonitrile/water (4:1, v/v) to stop lipolysis, vortexed for 1 min and centrifuged at 4500 g for 5 min to precipitate proteins prior to analysis. The supernatant will be analyzed by HPLC-MS for residual compound concentrations, and the potential products of compound hydrolysis analyzed.

To provide for higher throughput of experiments, unless otherwise stated, in vitro hydrolysis of test compounds will generally be performed via incubation with porcine pancreatic lipase. This provides a more reproducible source of pancreatic enzymes, facilitates enhanced experimental throughput, and is also a greater challenge than collected rat enzymes (since enzyme activity in rat intestinal fluid is low). Briefly, pancreatic lipase solution will be prepared prior to the hydrolysis experiment by dispersion of 1 g porcine pancreatin in 5 ml of lipolysis buffer and 16.9 μL of 0.5 M NaOH. The suspension will be mixed well and centrifuged at 3500 rpm for 15 minutes at 5° C. to provide a supernatant. An amount of 1000 mL of lipolysis buffer will be prepared with 0.474 g of tris-maleate (2 mM), 0.206 g of CaCl₂.H₂O (1.4 mM) and 8.775 g of NaCl (150 mM) adjusted with NaOH to pH 6.5. To assess the potential for prodrug hydrolysis in the intestine, 20 μL of prodrug solution (1 mg/mL dissolved in acetonitrile), 900 μL of simulated intestinal micellar solution [prepared with 0.783 g of NaTDC (3 mM) and 0.291 g of phosphatidyl choline (0.75 mM) in 500 mL lipolysis buffer] and 100 μL of enzyme solution will be incubated at 37° C. 20 μL samples of the incubation solution will be taken at 0, 5, 10, 15, 30, 60, 90, 120 and 180 minutes post incubation and added to 180 μL of MeCN to stop lipolysis. The mixture will be vortexed and centrifuged at 5000 rpm for 5 minutes to precipitate proteins prior to analysis. The supernatant will be analyzed by HPLC-MS for residual compound concentrations, and the potential products of compound hydrolysis analyzed.

On incubation with digestive enzymes, the monoglyceride forms of the prodrugs are formed very rapidly. The stability in simulated intestinal conditions is therefore better assessed by the stability of the monoglyceride form that is generated by the initial digestion process. The monoglyceride form must remain intact to be absorbed and re-esterified in the enterocyte prior to entry into the lymphatics. A comparison of the stability profiles of the monoglyceride forms of test compounds during in vitro incubation with freshly collected rat bile and pancreatic fluid (BPF) or porcine pancreatic lipase will be used to evaluate the influence of linker structure on the stability of the monoglyceride intermediates.

Example 39: In Vitro Release of Therapeutic Agent From Prodrugs in Lymph Supplemented with Lipoprotein Lipase

In order to probe the release of free therapeutic agent from lipid prodrugs in the lymphatics, prodrugs will be incubated with rat lymph supplemented with lipoprotein lipase (LPL, 200 unit/mL). LPL is a key enzyme required for the hydrolysis of lipoprotein associated TG in normal physiological conditions and is therefore expected to be a key contributor to lipolysis of the re-esterified drug-TG construct in plasma, largely via liberation of fatty acids in the sn-1 and the sn-3 position of the TG-mimetic, prior to drug release from the 2′ positon via esterase hydrolysis. LPL is tethered to lymphocytes or lymphatic/vascular endothelial cells under physiological conditions. In these in vitro studies, rat lymph will therefore be supplemented with LPL to better reflect the in vivo situation. To start hydrolysis, 10 μL of LPL solution (10,000 unit/ml) will be added to a mixture of 10 μL of prodrug solution (1 mg/mL dissolved in acetonitrile) and 500 μL of blank Sprague Dawley rat lymph. The solution will be incubated at 37° C. Samples (20 μL) of the incubation solution will be taken at 0, 5, 10, 15, 30, 60, 90, 120 and 180 minutes post incubation and added to 980 μL of 9:1 (v/v) MeCN/water to stop lipolysis. The mixture will be vortexed and centrifuged at 4500 g for 5 minutes to precipitate proteins prior to analysis. The supernatant will be analyzed by HPLC-MS/MS for concentrations of the released therapeutic agent.

Example 40: Lymphocyte Proliferation Assay

Immune cells from rats (MLN and spleen cells) and PBMCs from human participants will be cultured in flat clear-bottom 96-well microplates (Thermo Scientific Nunc®) at a concentration of 8.4×104 and 5.2×104 cells/well, respectively. Working stock solutions of test and control compounds in RMPI-1640 culture medium-DMSO (99:1, v/v) will be prepared at concentrations of 10, 25, 50, 75, 100, 150, and 200m/mL. Working stock solutions of test and control compounds will be incubated with cells at final concentrations of 1, 2.5, 5, 7.5, 10, 15, and 20 μg/mL in a humidified atmosphere of 5% CO₂ at 37° C. for 30 min. Cells will then be stimulated by the T cell-selective mitogen Phytohaemagglutinin (PHA, 10 μg/mL, Sigma Aldrich; see Janossy, G. et al., Clin. Exp. Immunol. 9, 483-& (1971)) or other stimulant such as Concanavalin A (ConA), and incubated in a humidified atmosphere of 5% CO₂ at 37° C. for 2 days. Cell proliferation will be assessed by enzyme-linked immunosorbent assay (ELISA) based on bromo-2′-deoxyuridine (BrdU) incorporation into newly synthesized DNA according to the manufacturer protocol (Roche Applied Science, Roche Diagnostics Ltd, UK). Finally, the absorbance of these wells will be observed at 370 nm, with reference wavelength at 492 nm using plate reader (EnVision® Multilabel Plate Reader, PerkinElmer Inc., USA). Absorbance values will be normalized to the absorbance of culture medium-treated cells.

Reference: Zgair, A. et al., Scientific Reports 2017, 7: 14542, 1-12.

Example 41: Flow Cytometry Analysis

Freshly isolated immune cells of MLN and splenocytes from rats and thawed PBMCs from human participants will be incubated with control or test compound (1-20 μg/mL) for 30 min in FACS tubes. Cells will then be stimulated with phorbol myristate acetate and ionomycin (PMA & I) in the presence of brefeldin A and incubated in a humidified atmosphere of 5% CO₂ at 37° C. for 5 hours. After stimulation, cells will be washed with PBS and centrifuged to pellet (290 g, 5 min, 20° C.). Cell pellet will be resuspended and labelled with Zombie UV™ Fixable Viability kit according to the manufacturer's protocol (Biolegend) for the purpose of excluding dead cells during the analysis of data (effect of relevant control compounds on the variability of immune cells isolated from healthy volunteers can be evaluated by methods known in the art). Fixation and permeabilization will be performed using BD Cytofix/Cytoperm™ kit according to the manufacturer's protocol (BD Bioscience). Rat immune cells will be labelled with APC anti-rat CD3, PE anti-mouse/rat TNF-α, and FITC anti-rat IFN-γ antibodies (Biolegend). Human PBMCs will be labelled with BV421 anti-human TNF-α and PerCP/Cy5.5 anti-human IL-2 antibodies (Biolegend), ECD anti-human CD3, FITC anti-human IFN-γ antibodies (Beckman Coulter), and PE anti-human IL-17A, and APC anti-human GM-CSF antibodies (eBioscience). Isotype and fluorescence minus one (FMO) controls will be prepared for all antibodies in each flow cytometry run. Data will be collected on MoFlo® Astrios™ EQ flow cytometer and analyzed using Kaluza analysis software v 1.5 (Beckman Coulter). An appropriate gating strategy may be selected using methods known in the art and the reference below.

Reference: Zgair, A. et al., Scientific Reports 2017, 7: 14542, 1-12.

Example 42: Preparation of Single-Cell Suspension From Mesenteric Lymph Node (MLN) and Spleen of Rats

Following 5 days of acclimatization, animals will be euthanized and the ventral abdominal wall incised to expose the intestine. MLN and spleen will be aseptically collected. MLN will be gently dissected from surrounding tissue and spleen will be scored with a clean scalpel before being mashed on cell strainer (70 μm Nylon, Corning Falcon™). Red blood cells in the cell suspension of the splenocytes will be lysed by lysing buffer (BD Bioscience). Immune cells from MLN and splenocytes will then be washed twice with PBS. Cell suspension will be centrifuged (400 g, 5 min at room temperature) and resuspended in complete RMPI-1640 culture medium (RMPI-1640 culture medium with L-glutamine supplemented with 10% fetal bovine serum (FBS) and 1% penicillin-streptomycin, all purchased, e.g., from Sigma-Aldrich) at concentration of 1.2×10⁶ cells/mL to be used for proliferation and flow cytometry experiments.

Reference: Zgair, A. et al., Scientific Reports 2017, 7: 14542, 1-12 and Han, S. et al., Journal of Controlled Release 2014, 177, 1-10.

Example 43: In Vitro Release of Therapeutic Agent From Prodrugs in Plasma Supplemented with Lipoprotein Lipase

In order to probe the release of free drug from TG prodrugs in the systemic circulation, prodrugs were incubated with plasma (rat, mouse, dog, pig or human) supplemented with lipoprotein lipase (LPL, 200 IU/ml). LPL is a key enzyme required for the hydrolysis of lipoprotein associated TG in the systemic circulation and is therefore expected to be a key contributor to lipolysis of the re-esterified drug-TG construct in plasma, largely via liberation of fatty acids in the sn-1 and the sn-3 position of the TG-mimetic, prior to drug release from the 2′ position via esterase hydrolysis. LPL is active in plasma but is tethered to the luminal surface of vascular endothelial cells under physiological conditions. In the current in vitro studies, plasma was therefore supplemented with LPL to better reflect the in vivo situation. To start hydrolysis, 10 μl of LPL solution (10,000 IU/ml) was added to a mixture of 10 μl of prodrug solution (1 mg/ml dissolved in acetonitrile) and 500 μl of blank plasma. The mixture was incubated at 37° C. Samples (20 μl) of the incubation solution were taken at 0, 5, 15, 30, 60, 90, 120 and 180 minutes post-incubation and added to 180 μl of MeCN to stop lipolysis. The mixture was vortexed and centrifuged at 4500×g for 5 minutes to precipitate proteins prior to analysis. The supernatant was analyzed by HPLC-MS/MS for the potential products (MG form, acid form, and free drug) of prodrug hydrolysis.

To assess the stability and release profile of compounds of the present invention, compounds TAC-I-18 and TAC-I-20 were incubated with rat plasma and the concentrations of compounds, parent drug tacrolimus, and acid were monitored by LCMS for about three hours. The plasma release profiles for TAC-I-18 are summarized in FIG. 20. The plasma release profiles for TAC-I-20 are summarized in FIG. 21.

Example 44: Oral Ovalbumin Challenge Model Purification and Labelling of Ovalbumin Specific T Cells

OVA specific CD4⁺ and CD8⁺ T cells were purified from the lymph nodes of OT2 and OT1 mice, respectively, and employed in independent experiments to simplify the studies. Lymph nodes collected from OT mice (including MLN, inguinal, brachial, axillary, cervical, iliac) were pressed through a 40 μm sieve using the back of 1 ml syringe plunger, to form a single cell suspension in RPMI 1640 with 2% Fetal Bovine Serum. T cells were then purified using negative selection separation and employing a magnet assisted cell sorting (MACS®) protocol from Miltenyi Biotec. The protocol provided in the kit supplied by Miltenyi Biotec was followed. Briefly, cell suspensions obtained from the lymph node of the OT mice were resuspended in MACS buffer (PBS with 2 mM EDTA and 0.2% Bovine Serum Albumin (BSA)) and labelled with antibodies against all other surface markers, except for the marker for the cells of interest (i.e. CD4+ T cells are isolated by depletion of non CD4+ T cells using a cocktail of biotin-conjugated antibodies against CD8a, CD11b, CD11c, CD19, CD45R (B220), CD49b (DX5), CD105, Anti-MHC-class II, Ter-119 and TCR γ/δ as primary labelling reagent). The cells were then incubated with Anti-biotin labelled magnetic microbeads and passed through the MACS LS column along with MACS buffer within the magnetic field of the Vario MACS separator. The labelled cells are retained within the column while the unlabelled cells flow through the column. The quantity of reagents used was as described in the kit. The purity of the isolated cells was confirmed by flow cytometry of a small sample. These cells were stained with antibodies to CD4 (OT2) or CD8 (OT1) and for Ly 5.1 (surface protein present in lymphocytes of OT mice). The purified CD4 or CD8 T cells were subsequently labelled with CellTrace violet (CTV) dye to allow downstream quantification of cell proliferation. CTV labelling was performed in two steps. First the CTV dye was diluted 100 fold (from 5 mM to 50 μM) with 0.1% BSA in PBS in an eppendorf tube. This solution was then further diluted 10 fold (to 5 μm) at the same time as adding to the cell suspension (≤50×10⁶ cells/ml) in a 10 mL Falcon tube. The tube was sealed and vortexed immediately to allow even distribution of the dye to the cells. The number of OT cells purified and thus labelled were counted using a haemocytometer under the microscope. The cells were then pelleted and resuspended in PBS, pH 7.4 (10⁷ cells/nil), for administration to the recipient mice.

Oral Ovalbumin Challenge Model (Late Dosing Protocol)

Recipient female C57B1/6 mice (20-22 g) were administered 50 mg ovalbumin in 0.2 mL of PBS as a single dose, by oral gavage on Day 1. A negative control group received only PBS (the saline “treatment” group). Each mouse was then administered ˜0.2 ml of the appropriate cell suspension containing 2×10⁶ donor cells, by the tail vein (from above; purified and labelled CD4 or CD8 T cells, obtained from donor OT mice), within 0.5-3 hours of ovalbumin administration. The ovalbumin dosed mice were then divided into four treatment groups and administered different treatments via oral gavage. One group received no additional treatment (OVA treated group), a second received 50 mg/kg parent drug (MPA) as a suspension in 0.2 ml of 0.5% CMC (MPA treatment group), a third received the MPA-2-TG prodrug at a dose equivalent to 50 mg/kg of MPA formulated in a lipid emulsion (MPA-2-TG treatment group) and the fourth received the blank lipid emulsion (blank lipid treatment group) in which the prodrug was administered. The treatments were administered on days 2, 3 and 4, twice a day in the morning and evening. The mice were killed on day 5 and mesenteric lymph nodes (MLN) and peripheral lymph nodes (PLN, including inguinal, brachial, axillary, cervical, iliac) were collected and analyzed by flow cytometry (as below) to assess the proliferation of ovalbumin specific T cells.

Flow Cytometry Analysis

For flow cytometry analysis, cells were isolated from the MLN and PLN and formed into a single cell suspension as described above in PBS buffer containing 2% Foetal Bovine Serum. The cells were then incubated for 20 mins at 4° C. with FITC anti-mouse CD45.1 antibody or FITC anti-mouse TCR Va2 antibody to label lymphocytes derived from the OT mice (for transgenic mice obtained from WEHI, TCR Va2 antibody was used, for mice from Bio21 CD45.1 antibody was employed). APC anti-mouse CD8a antibody was used to label CD8 cells and PE anti-mouse CD4 antibody to label CD4 cells. Cells were then washed with buffer. All antibodies were used as per the dilution suggested by the commercial (Biolegend) labelling procedure. Propidium iodide, 10 ng/ml, was added to the cells just prior to flow cytometry analysis to stain for dead cells. Cells that were double positive for CD4/CD8 and CD45.1 (i.e. CD4 or CD8 lymphocytes derived from OT mice) were selected to detect the CTV fluorescence, using the Pacific blue filter (450/50). One million total events were acquired by the flow cytometer (BD Biosciences FACSCanto II analyser, Becton, Dickinson and Company, NJ, USA) and data were analysed using FlowJo software, by Tree Star Inc., Ashland, Oreg., USA.

Example 45: Lymph Transport Study in Beagle Dogs

A modified version of protocols described in Han, S. et al., “Lymphatic Transport and Lymphocyte Targeting of a Triglyceride Mimetic Prodrug Is Enhanced in a Large Animal Model: Studies in Greyhound Dogs,” Mol. Pharm. 2016, 13 (10), 3351-3361, may be used to perform lymph transport assays of test compounds in beagle dogs. The assay will be performed as follows.

The thoracic lymph duct will be cannulated under surgical anesthesia as previously described (Edwards, et al. Adv. Drug Delivery Rev. 2001, 50 (1-2), 45-60.). Following surgery, dogs will be allowed to recover unrestrained in a closed run overnight (12-16 h) and returned to normal ambulatory movement before commencement of the study. In the initial recovery period fluids will be administered IV to ensure adequate hydration and to prevent hypoproteinemia. Water will be also available ad libitum throughout the experiment period. Prior to drug administration, a 20 G intravenous catheter will be inserted into the cephalic vein to enable serial blood sampling and the catheter kept patent by periodic flushing with heparinized saline (1 IU/mL). To limit possible dehydration due to the continuous collection of thoracic lymph, 25 mL of normal saline will be also administered hourly by IV bolus during the sampling period. The dogs will be fasted for 12 h up to 30 min prior to drug administration. For fed state studies, dogs will receive ˜20 g of high fat dog food (containing ˜34% fat), administered by hand, followed by 10 mL water to aid in swallowing, followed by 100 g standard canned dog food (˜2.5% fat) 30 min prior to drug administration. Water will be available ad libitum throughout the study for all dogs. Test compounds may be prepared in a suitable formulation such as a long-chain lipid based self-emulsifying drug delivery system (SEDDS) consisting of 30.5% w/w soybean oil, 30.5% w/w Maisine-CC, 31.6% w/w Cremophor EL and 7.4% w/w ethanol. Formulations may be filled into hard gelatin capsules. Compound dissolved in the formulation may be administrated to the fed dog by placing the capsules as far posterior to the pharynx as possible, closing the mouth and rubbing the throat to stimulate swallowing. Subsequently 50 mL of water will be administered orally via a syringe. Lymph will be collected continuously into preweighed 50 mL collection tubes containing 75 mg of disodium EDTA for the duration of the 10 h postdosing period. Individual lymph samples for each half hourly or hourly collection period will be combined, and the mass of lymph collected will be determined gravimetrically. Several 20 and 200 μL aliquots of each lymph sample will be transferred into individual 1.5 mL Eppendorf tubes and stored at −80° C. until analysis of drug concentrations. The remaining lymph from each collection period (half hourly or hourly) will be transferred into 10 mL tubes, which will be centrifuged at 2000 g for 10 min to obtain lymphocyte pellets, which will be stored at −80° C. until analysis of drug concentrations. Systemic blood samples (3 mL) will be taken via the indwelling cephalic vein catheter and placed in individual heparinized tubes (13×75 mm BD Vacutainer, 68 IU). Blood samples will be collected at predose (−5 min) and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, and 10 h following drug administration. Plasma will be separated by centrifugation and stored at −80° C. prior to analysis. 

We claim:
 1. A compound of Formula X-a or X-h:

or a pharmaceutically acceptable salt thereof, wherein: R¹ and R² are each independently hydrogen, an acid-labile group, a lipid, or —C(O)R³; each R³ is independently a saturated or unsaturated, straight or branched, optionally substituted C₁₋₃₇ hydrocarbon chain; each R⁴ and R⁵ is independently hydrogen, deuterium, halogen, —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁴ or R⁵ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur; provided that at least one instance of R⁴ is not hydrogen and at least one instance of R⁵ is not hydrogen; each R is independently hydrogen or an optionally substituted group selected from C₁₋₆ aliphatic, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur; -M- is a self-immolative group; and A is a therapeutic agent.
 2. The compound according to claim 1, wherein R¹ and R² are —C(O)R³.
 3. The compound according to claim 1, wherein each R³ is independently a saturated or unsaturated, unbranched C₂₋₃₇ hydrocarbon chain.
 4. The compound according to claim 1, wherein the compound is of Formula X-c:

or a pharmaceutically acceptable salt thereof.
 5. The compound according to claim 1, wherein the compound is of Formula X-e:

or a pharmaceutically acceptable salt thereof.
 6. The compound according to claim 1, wherein the compound is of Formula X-f:

or a pharmaceutically acceptable salt thereof.
 7. The compound according to claim 1, wherein the compound is of Formula XI-a:

or a pharmaceutically acceptable salt thereof.
 8. The compound according to claim 1, wherein the compound is of Formula XI-b:

or a pharmaceutically acceptable salt thereof.
 9. The compound according to claim 1, wherein -M- is selected from one of the following:

wherein each R⁶ is independently selected from hydrogen, deuterium, C₁₋₁₀ aliphatic, halogen, or —CN; each R⁷ is independently selected from hydrogen, deuterium, halogen, —CN, —OR, —NR₂, —NO₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C₁₋₆ aliphatic group optionally substituted with —CN, —OR, —NR₂, —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C₁₋₆ aliphatic is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; each Z¹ is independently selected from —O—, —NR—, or —S—; each Z² is independently selected from —O—, —NR—, —S—, —OC(O)—, —NRC(O)O—, or —OC(O)NR—; each Z³ is independently selected from ═N— or ═C(R⁷)—; and each Z⁴ is independently selected from —O—, —NR—, —S—, —C(R⁶)₂—, or a covalent bond.
 10. The compound according to claim 9, wherein -M- is selected from


11. The compound according to claim 9, wherein -M- is selected from


12. The compound according to claim 1, wherein each R⁴ is independently hydrogen, deuterium, halogen, —CN, or C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁴ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur; provided that at least one instance of R⁴ is not hydrogen.
 13. The compound according to claim 1, wherein each R⁵ is independently hydrogen, deuterium, halogen, —CN, or C₁₋₄ aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R⁵ attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur; provided that at least one instance of R⁵ is not hydrogen.
 14. The compound according to claim 1, wherein each R⁴ and R⁵ is independently hydrogen or C₁₋₄ alkyl optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; provided that at least one instance of R⁴ is not hydrogen and at least one instance of R⁵ is not hydrogen.
 15. The compound according to claim 14, wherein one instance of R⁴ is C₁₋₄ alkyl and one instance of R⁵ is C₁₋₄ alkyl.
 16. The compound according to claim 1, wherein A is selected from an immunomodulatory therapeutic agent.
 17. The compound according to claim 16, wherein the immunomodulatory therapeutic agent is selected from thalidomide, lenalidomide, pomalidomide, apremilast, azathioprine, mycophenolic acid, leflunomide, teriflunomide, methotrexate, a macrolide IL-2 inhibitor, tacrolimus, sirolimus (Rapamune®), everolimus (Certican™), CCI-779, ABT578, temsirolimus, TAFA-93, vistusertib, ciclosporin, pimecrolimus, abetimus, or gusperimus.
 18. (canceled)
 19. A pharmaceutical composition comprising a compound according to claim 1, and a pharmaceutically acceptable carrier, adjuvant, or vehicle.
 20. The pharmaceutical composition according to claim 19, further comprising an additional therapeutic agent.
 21. A method of treating a disease, disorder, or condition in a patient in need thereof comprising administering to said patient an effective amount of a compound according to claim
 1. 22. The method according to claim 21, wherein the disease, disorder, or condition is one of those recited in Tables 1 through
 7. 23. The compound of claim 1, wherein one instance of R⁴ is methyl and one instance of R⁵ is methyl.
 24. The compound according to claim 1, wherein the therapeutic agent is selected from testosterone, mycophenolic acid (MPA), buprenorphine, oestrogens (estrogen), opiates, tetrahydrocannabinol (THC), cannabidiol, metoprolol, raloxifene, alphaxolone, statins, pentazocine, propranolol, L-DOPA, lidocaine, chlorpromazine, sertraline, amitriptyline, nortriptyline, pentazocine, glyceryl trinitrate, oxprenolol, labetalol, salbutamol, epitiostanol, melphalan, lovastatin, non-steroidal antiinflammatory medications (NSAIDS), COX-2 inhibitors, corticosteroid anti-inflammatory medications, anti-malarial medications, nitrosoureas, methotrexate, dactinomycin, anthracyclines, mitomycin C, bleomycin, mithramycin, drugs acting on immunophilins, sulfasalazine, leflunomide, fingolimod, myriocin, chlorambucil, doxorubicin, nelarabine, cortisone, pralatrexate, vinblastine, bortezomib, nelarabine, clofarabine, cytarabine, dasatinib, imatinib mesylate, ponatinib hydrochloride, vincristine sulfate, bendamustine hydrochloride, fludarabine phosphate, bosutinib, nilotinib, omacetaxine mepesuccinate, capecitabine, paclitaxel, gemcitabine, fulvestrant, tamoxifen, lapatinib, toremifene, ixabepilone, eribulin, albendazole, ivermectin, diethylcarbamazine, albendazole, doxycycline, closantel, maraviroc, enfuvirtide, deoxythymidine, zidovudine, stavudine, didanosine, zalcitabine, abacavir, lamivudine, emtricitabine, tenofovir, delavirdine, rilpivirine, raltegravir, elvitegravir, lopinavir, indinavir, nelfinavir, amprenavir, ritonavir, and acyclovir; or a pharmaceutically acceptable salt thereof.
 25. The compound according to claim 1, wherein the therapeutic agent is selected from morphine, atorvastatin, aspirin, ibuprofen, naproxen, celecoxib, prednisolone, prednisone, dexamethasone, hydroxychloroquine, daunorubicin, cyclosporin, tacrolimus, and sirolimus.
 26. The compound according to claim 1, wherein the therapeutic agent is selected from testosterone, mycophenolic acid (MPA), buprenorphine, tetrahydrocannabinol (THC), cannabidiol, celecoxib, and dexamethasone. 